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Maternal Obesity and Pregnancy Outcome: in Perspective of New Asian Indian Guidelines

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Abstract

Background

Prevalence of obesity among women of reproductive age is increasing worldwide. As the prevalence increases among the women of reproductive age group, so it does among pregnant females. This study was conducted with the aim to assess obesity-related adverse maternal, neonatal and perinatal outcomes using new Asian Indian guidelines.

Methodology

Pregnant women up to 16-week gestation on first visit were enrolled. There were two exposure groups: one with BMI < 25 kg/m2 and second with BMI ≥ 25 kg/m2 matched for maternal age and parity, 100 in each group. The study focused on development of various adverse maternal and foetal/perinatal complications. Comparative analysis of data was done to estimate the odds of each outcome taking non-obese group as reference.

Results

There was a significant increase in risk among obese mothers compared to non-obese mothers for maternal complications like hypertensive disorders of pregnancy{OR 3.83}, preeclampsia{OR 9.2}, gestational diabetes mellitus{OR 4.85} and insulin requirement{OR 12.46}, induction of labour{OR 2.71}, caesarean section post induction{OR 8.50}, prolonged labour{OR 4.69}, caesarean sections{OR 5.18} and postpartum haemorrhage{OR 2.21}. Also, there was a significant increase in risk among obese mothers compared to non-obese mothers for foetal and perinatal complications like miscarriages{OR 4.85}, preterm newborns{OR 4.63}, medically indicated preterm{OR 6.59}, shoulder dystocia{OR could not be calculated}, large for gestational age{OR 5.91}, hyperbilirubinaemia {OR 4.26} and neonatal intensive care unit admissions{OR 3.26}.

Conclusion

It was concluded that obesity defined by Asian Indian guidelines (BMI ≥ 25 kg/m2) is associated with adverse pregnancy outcomes at odds comparable to western studies with obesity taken as BMI ≥ 30 kg/m2.

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References

  1. 1.

    Obesity and overweight. World Health Organization. 2018 [cited 2018 February 16]. http://www.who.int/mediacentre/factsheets/fs311/en/#.

  2. 2.

    Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81.

  3. 3.

    Jain D, Khuteta R, Chaturvedi V, Khuteta S. Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies: observational study. J Obstet Gynaecol India. 2012;62(4):429–31.

  4. 4.

    Dasgupta A, Harichandrakumar KT, Habeebullah S. Pregnancy outcome among obese Indians-a prospective cohort study in a tertiary care centre in south India. Int J Sci Study. 2014;2(2):13–8.

  5. 5.

    Quiner T, Perlow JH. The global burden of obesity on pregnancy outcomes in the developed world [17Q]. Obstet Gynecol. 2017;1(129):177S.

  6. 6.

    State Fact Sheet. Tamilnadu. National Family Health Survey-4. 2015–16 [cited 2016 July 20]. http://rchiips.org/NFHS/pdf/NFHS4/TN_FactSheet.pdf.

  7. 7.

    District Fact Sheet. Salem. Tamilnadu. National Family Health Survey-4. 2015–16 [cited 2016 July 20]. http://rchiips.org/NFHS/FCTS/TN/Salem.pdf.

  8. 8.

    Deurenberg-Yap M, Chew SK, Lin VF, Tan BY, Van Staveren WA, Deurenberg P. Relationships between indices of obesity and its co-morbidities in multi-ethnic Singapore. Int J Obes Lond. 2001;25(10):1554.

  9. 9.

    Misra A, Chowbey P, Makkar BM, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Phys India. 2009;57:163–70.

  10. 10.

    Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S. Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health. 2007;7(1):1.

  11. 11.

    Menon RM, Isac M. Impact of body mass index on pregnancy outcome: a prospective cohort study. Paripex Indian J Res. 2019;8(2):7–9.

  12. 12.

    Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300:2286.

  13. 13.

    Bodnar LM, Ness RB, Harger GF, Roberts JM. Inflammation and triglycerides partially mediate the effect of prepregnancy body mass index on the risk of preeclampsia. Am J Epidemiol. 2005;162(12):1198–206.

  14. 14.

    Seshiah V, Kapur A, Balaji V, et al. Targeting glycemic level in gestational diabetes mellitus to that of normal pregnancy would result in a better maternal-fetal outcome. J Assoc Phys India. 2019;67:66.

  15. 15.

    Feresu SA, Wang Y, Dickinson S. Relationship between maternal obesity and prenatal, metabolic syndrome, obstetrical and perinatal complications of pregnancy in Indiana, 2008–2010. BMC Pregnancy Childbirth. 2015;15(1):266.

  16. 16.

    Vijay A, Maran G, Koothan V. Impact of maternal obesity on obstetric outcome in a rural population in Pondicherry. Int J Reprod Contracept Obstet Gynecol. 2015;4(3):740–4.

  17. 17.

    Avcı ME, Şanlıkan F, Çelik M, Avcı A, Kocaer M, Göçmen A. Effects of maternal obesity on antenatal, perinatal and neonatal outcomes. J Matern Fetal Neonatal Med. 2015;28(17):2080–3.

  18. 18.

    Wolfe KB, Rossi RA, Warshak CR. The effect of maternal obesity on the rate of failed induction of labor. Am J Obstet Gynecol. 2011;205(128):e1.

  19. 19.

    Zhang J, Bricker L, Wray S, Quenby S. Poor uterine contractility in obese women. BJOG. 2007;114(3):343–8.

  20. 20.

    Cedergren MI. Non-elective caesarean delivery due to ineffective uterine contractility or due to obstructed labour in relation to maternal body mass index. Eur J Obstet Gynecol Reprod Biol. 2009;145(2):163–6.

  21. 21.

    Brost BC, Goldenberg RL, Mercer BM, et al. The Preterm Prediction Study: association of cesarean delivery with increases in maternal weight and body mass index. Am J Obstet Gynecol. 1997;177:333.

  22. 22.

    Chu SY, Kim SY, Schmid CH, et al. Maternal obesity and risk of cesarean delivery: a meta-analysis. Obes Rev. 2007;8(5):385–94.

  23. 23.

    Fyfe EM, Thompson JM, Anderson NH, et al. Maternal obesity and postpartum haemorrhage after vaginal and caesarean delivery among nulliparous women at term: a retrospective cohort study. BMC Pregnancy Childbirth. 2012;12:112.

  24. 24.

    Seehra N, Khichar M. Obesity and outcome of pregnancy: a comparative study of obese versus non obese pregnant women. Diabetes. 2016;11(18.33):1.

  25. 25.

    Callaway LK, Prins JB, Chang AM, McIntyre HD. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust. 2006;184(2):56–9.

  26. 26.

    Tayade S, Singh R, Kore J, Gangane N. Maternal anthropometric measurements, pre-pregnancy body mass index, and fetal growth parameters-a rural experience. Obstet Gynecol Res. 2018;1(2):51–64.

  27. 27.

    Hincz P, Borowski D, Krekora M, Podciechowski L, Horzelski W, Wilczyński J. Maternal obesity as a perinatal risk factor. Ginekol Pol. 2009;80(5):334–7 PubMed PMID: 19548451.

  28. 28.

    McDonald SD, Han Z, Mulla S, Beyene J. Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ. 2010;341:c3428.

  29. 29.

    Leung TY, Leung TN, Sahota DS, et al. Trends in maternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinese women. BJOG. 2008;115(12):1529–37.

  30. 30.

    Rougée LR, Miyagi SJ, Collier AC. Obstetric obesity is associated with neonatal hyperbilirubinemia with high prevalence in native hawaiians and pacific island women. Hawaii J Med Public Health. 2016;75(12):373.

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Author information

Correspondence to Imran Kutchi.

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Conflict of interest

Imran Kutchi, P. Chellammal and A. Akila declare that we have no conflict of interest to declare.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Sri Gokulam Hospital Ethical Committee, Salem, Tamilnadu) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and Animal Rights

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Dr. Imran Kutchi is an Ex DNB Resident, Sri Gokulam Hospital and also Consultant OBGYN, Khushbu Hospital, Botad; Dr. P. Chellammal is a Consultant and Head of Department, Department of OBGYN, Sri Gokulam Hospital, Salem; Dr. A. Akila is a Consultant, Department of OBGYN, Sri Gokulam Hospital, Salem.

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Kutchi, I., Chellammal, P. & Akila, A. Maternal Obesity and Pregnancy Outcome: in Perspective of New Asian Indian Guidelines. J Obstet Gynecol India (2020). https://doi.org/10.1007/s13224-019-01301-8

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Keywords

  • Maternal obesity
  • Asian guidelines
  • Pregnancy outcome
  • Perinatal outcome