Peer Review #1 of "Association of pre-pregnancy body mass index with adverse pregnancy outcome among first-time mothers (v0.1)"

Abstract Objectives There 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. Methods An 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. Results Incidence 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. Conclusions Data 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 Sources The financial assistance for present study was provided by the University Grant Commission (UGC), Government of India, under Junior/Senior Fellow Scheme.

Download Full-text

Hyperglycemia and Adverse Pregnancy Outcome Study: Associations With Maternal Body Mass Index

Obstetrical & Gynecological Survey ◽

10.1097/ogx.0b013e3181e5f1ad ◽

2010 ◽

Vol 65 (7) ◽

pp. 419-421

Keyword(s):

Body Mass Index ◽

Pregnancy Outcome ◽

Body Mass ◽

Adverse Pregnancy Outcome ◽

Maternal Body Mass Index ◽

Outcome Study ◽

Maternal Body ◽

Adverse Pregnancy

Download Full-text

Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study: associations with maternal body mass index

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2009.02486.x ◽

2010 ◽

Vol 117 (5) ◽

pp. 575-584 ◽

Cited By ~ 219

Author(s):

Keyword(s):

Body Mass Index ◽

Pregnancy Outcome ◽

Body Mass ◽

Adverse Pregnancy Outcome ◽

Maternal Body Mass Index ◽

Maternal Body ◽

Adverse Pregnancy

Download Full-text

Study of pregnancy outcome in relation to first trimester body mass index

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194598 ◽

2019 ◽

Vol 8 (11) ◽

pp. 4187

Author(s):

Prachi Srivastava ◽

Hema Verma

Keyword(s):

Body Mass Index ◽

Pregnancy Outcome ◽

Body Mass ◽

Adverse Pregnancy Outcome ◽

Multiple Pregnancy ◽

First Trimester ◽

Large For Gestational Age ◽

Singleton Pregnancy ◽

Adverse Pregnancy ◽

High Bmi

Background: Early pregnancy body mass index (BMI) plays an important role in pregnancy outcome. Women with either low or high BMI have an adverse pregnancy outcome. American college of obstetricians and gynecologists (ACOG) recommends calculation of BMI for all pregnant women at their first visit. This study was conducted to assess maternal and fetal outcome in women based on first trimester BMI.Methods: This was a prospective observational study conducted in Department of Obstetrics and Gynecology of T. S. Misra Medical college and hospital, Lucknow from January 2018 to January 2019. Patients with singleton pregnancy booked in first trimester were included while women with multiple pregnancy, pre-existing medical conditions were excluded from the study. Proper history taking and examination was done, and patients divided into five groups as per guidelines of WHO and National Institute of Health Guidelines. Patients were followed up during entire antenatal period. Any maternal and fetal complications were recorded.Results: Incidence of anemia and intrauterine growth restriction (IUGR) was seen more in underweight patients. Postpartum hemorrhage (PIH), gestational diabetes and macrosomia was associated more with patients who were overweight or obese. There was significantly more incidence of lower (uterine) segment caesarean section (LSCS), instrumental delivery, wound sepsis and PPH in patients with higher BMI. SGA babies were seen more in patients with low BMI while large for gestational age (LGA) babies were seen more in patients with high BMI. More neonatal intensive care unit (NICU) admissions were seen in patients with low or high BMI.Conclusions: Complications during pregnancy and adverse pregnancy and neonatal complication was seen significantly more in patients on either side of BMI (underweight and obese). Hence it can be concluded that BMI of a patient directly affects pregnancy outcome.

Download Full-text