A Study Of First Trimester Maternal Body Mass Index And Gestational Weight Gain And Their Association With Maternal And Perinatal Outcomes

Abstract

Background & Objective The maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) is known to affect birth weight but their separate and joint associations with complications of pregnancy and delivery are unclear. The increasing incidence of obesity among women worldwide1 has become one of the most significant public health concerns. High maternal body mass index (BMI) is related to adverse maternal pregnancy outcomes such as pre-eclampsia, eclampsia, Gestational diabetes mellitus (GDM),pre- and post-term delivery, induction of labour, macrosomia, caesarean section, and postpartum haemorrhage. While, low maternal body mass index is related to low birth weight baby, small for gestation, intrauterine growth restriction(IUGR) and high incidence of NICU admission.. In 1990, the Institute of Medicine of the National Academies in the United States suggested that maternal weight gain during pregnancy should be based on prepregnancy BMI. In this study we aim to investigate the association of first trimester BMI and GWG with maternal and perinatal outcome. Methodology The present one year cross sectional study was conducted in the Department of Obstetrics and Gynaecology, KLE’s Dr Prabhakar Kore Charitable Hospital, and Medical Research Centre, Belagavi. A total of 462 pregnant women in 1st trimester were enrolled in the study. In order to explore the relationship between maternal first trimester Body Mass Index, GWG and their association with maternal and perinatal outcomes, participants were categorized into three groups based on their first trimester Body Mass Index. The data was analysed using Chi-square tests. Differences were considered significant if p < 0.05. Results Among 462 mothers, majority of patients were in age group of 20-29 years accounting for 88.32%. Primigravida (49.13%) and multigravida (50.87%) were equally distributed.56.28% patients of the study were in normal BMI group, 31.39% were overweight BMI group and 12.34% were low BMI group.Out of 462 patients 68.61% patients had gained ≤10 kg weight during her pregnancy period whereas rest had gained >10kg.In our study, 67.32% patients had vaginal delivery followed by 31.82% underwent caesarean section. In our study, 82.46% low BMI patients had gained ≤ 10 kg weight. Whereas, 42.07% gained >10 kg of weight during their pregnancy.15.79% patients of low BMI group had preterm deliveries and 81.38% of overweight BMI patients had term deliveries.Maximum patients of our study had vaginal deliveries as compared to caesarean section accounting 73.68% patients from Low BMI group. While caesarean section weremaximum in overweight BMI group. In this study, 78.35% neonates had ≥2.5kg birth weight.43.86% of low BMI group mothers had low birth weight neonates. While 86.21% overweight mothers had >2.5 kg of birth weight neonates.Out of 462 patients 98 patients had maternal complications with incidence of preeclampsia(20) and GDM(14) were higher in overweight BMI group. 82 had perinatal complications. 14.72% neonates were IUGR, 2.38% neonates were macrosomia and 0.65% were stillbirth. Maximum IUGR (30) found in normal BMI patients and all macrosomia(11) found in overweight BMI patients. Conclusions The present revealed that an increased maternal BMI is associated with increased risk of adverse obstetric and perinatal outcomes.These include increased risk of preeclampsia, GDM, fetal macrosomia. Low maternal BMI was associated with IUGR, low birth weight, still birth and preterm deliveries