Impact of High Pre-Pregnancy Body Mass Index on Pregnancy Outcome Among Women Residing in Urban North-West Delhi, India

Abstract

ObjectivesThere is emerging evidence regarding the association of maternal overweight/obesity with an array of pregnancy-related complications and adverse pregnancy outcome. The present study aimed to evaluate the impact of higher pre- pregnancy body mass index (BMI) on pregnancy outcomes of women belonging to the upper socio-economic strata of North West Delhi. MethodsAn observational longitudinal study was conducted among 312 pregnant women attending the private antenatal clinics in North-West, Delhi, India during July 2018 to March 2020. Only women with pre-pregnancy BMI: >18.5kg/m2 who belonged to upper socio-economic strata and with confirmed singleton pregnancies were included in study. All the eligible subjects were enrolled at ≤ 16th week of their pregnancies and further stratified on basis of pre-pregnancy BMI criteria for the Asian-Indians,2009 i.e.,: normal weight;18.5–22.9kg/m2 (n:90), overweight; 23–24.9 kg/m2 (n = 90) and obese; ≥25 kg/m2 (n = 132). The primary outcome of study was macrosomia (birth weight: >3.5kg). Secondary outcomes were gestational diabetes mellitus (GDM), hypothyroid, pre-eclampsia (PE), pre-term birth (PTB), cesarean section (CS), neonatal intensive care unit (NICU) admission, miscarriage and still birth. Mixed and fixed-effects logistic regression analysis was performed with normal weight category women as a reference group. ResultsIncidence of adverse pregnancy outcome increased as pre-pregnancy BMI increases. Obese and overweight women had greater risk of undergoing CS (OR: 0.97, 95% CI: 0.9–1.05) and delivering a macrosomic neonate (OR = 2.36, 95% CI: 0.38–14.81 and OR = 1.03, 95% CI: 0.18–5.82) than normal weight women. Neonates of obese (OR: 1.30, 95%, CI:0.67–2.52) and overweight (OR: 1.33, 95% CI: 0.67–2.66) women had a higher risk of NICU admissions. ConclusionsData indicated detrimental effect of higher pre-pregnancy BMI for both mother and as well as the neonate. It would be prudent to strive for normal pre-pregnancy BMI to reduce the likelihood of adverse pregnancy outcome and lay a healthy foundation for an offspring. Funding SourcesThe financial assistance for present study was provided by the University Grant Commission (UGC), Government of India, under Junior/Senior Fellow Scheme.