BMI in Pregnancy
BMI in Pregnancy
BMI in Pregnancy
Abstract Introduction
Background: To examine the maternal and foetal risks of adverse Obesity has reached epidemic proportions globally, with
pregnancy outcome in obese women (BMI > 30). more than one billion adults overweight and is a major con-
tributor to the global burden of chronic disease and disabil-
Methods: This study is a prospective non randomized descriptive
ity. The increasing epidemic is equally relavent to the carers
study conducted in the Department of Obstetrics and Gynaecology
of pregnant women in UK [1].The prevalence of obesity in
of KIMS in Narketpally from April 2007 to April 2009, 100 women
with high BMI were compared with 100 women with normal BMI UK has trebled since 1980. According to CEMACH 2004
with regard to ante-natal complications, intervention in labour, ma- Report says 35% deaths mothers were obese (BMI > 30 kg/
ternal morbidity and neonatal outcome. m2) [2].
Incidence of obesity is on the rise in India as well. In a
Results: Compared to women with normal BMI, the following out- study done by Shukla HC et al [3] in Mumbai urban popula-
comes were significantly more common in obese pregnant women tion, the incidence of obesity in adults was found to be as
(odds ratio (95% confidence interval)) for BMI > 30 gestational high as 37.5%.
diabetes mellitus (4.8 (1.01 - 3.02)); pre-eclampsia (2.52 (1.04 - A generally accepted definition of obesity is a body mass
6.11)); macrosomia (13.8 (3.1 - 60.57)); caesarean section (3.45 index [4] (BMI) > 30 kg/m2 (Table1). Increased obesity rates
(1.65 - 7.15)) and infections (1.7 (0.39 - 7.32)).
among pregnant women are a significant public health con-
cern with various implications for pre natal care and supervi-
Conclusions: This study points out a strong association between
maternal morbid obesity in early pregnancy and a number of threat- sion of delivery. In pregnancy, BMI is calculated using pre
ening complications during pregnancy, delivery, and in the neonatal pregnant weight. If this is unknown, the first weight mea-
period. surement at prenatal care is used. Booking body mass index
(BMI) is of clinical interest since obese pregnant women
face far greater risks of pregnancy complications like pre-
Keywords: High body mass index; Obesity (BMI); Pregnancy eclampsia, gestational diabetes and macrosomia. Awareness
complications; Macrosomia of these findings needs to be increased in both women plan-
ning a pregnancy and their careers.
Methods
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Sujatha et al J Clin Gynecol Obstet 2012;1(1):15-18
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High BMI in Pregnancy J Clin Gynecol Obstet 2012;1(1):15-18
women and 44 of obese women had induction of labor, 6 of is previous bariatric surgery is not associated with adverse
non obese and 14 of obese women had instrumental delivery perinatal outcome although the study showed high cesarean
and 12 of non obese and 32 of obese women had cesarean rate and an increased risk of anaemia [6]. Olson et al evalu-
section which was statistically significant. Two non obese ated the efficacy of an intervention, which was that health-
and 22 of obese women had macrosomia, two non obese and care providers monitored gestational weight gain and send
8 of obese women had low APGAR score, four non obese patient education leaflets by mail to these women and this
and two of obese women had meconium stained liquor dur- reduced the risk of excessive weight gain and self monitor
ing labour and required admission to the neonatal unit and weight gain [12].
required assistance with feeding. Blood loss, urinary tract
infection, genital tract infection and wound infection were Conclusion
greater in the group of women with increased BMI.
This study, however, clearly demonstrates the increased risk
associated with embarking upon a pregnancy when over-
Discussion weight and shows that this group of women need to be re-
garded as high risk when counseling and risk assessment is
Obesity is a growing epidemic and its effect on the outcome done in the antenatal clinic. It has been recommended that
of pregnancy and delivery in the Indian population has not all mothers should have their BMI calculated at booking as a
hitherto been extensively studied. This study is a prospec- part of the full risk assessment and should be offered advice
tive study and aims to report the effect of maternal obesity about sensible weight reduction, including diet and exercise
on pregnancy complications. An increasing trend towards and referral to a dietician where appropriate.
obesity was found over the last 10 years, and at present, one- Research is needed into creation of an effective afford-
third of UK pregnant population has a BMI > 30.This study able and acceptable community based program for obese
detected a higher incidence of gestational diabetes and mac- pregnant women and their carers.
rosomia which has been consistently reported by other au-
thors [4, 7, 8]. Therefore it is pertinent to identify women at
risk of gestational diabetes as this increases the risk of hyper- References
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Articles The authors | Journal compilation J Clin Gynecol Obstet and Elmer Press | www.jcgo.elmerpress.com 17
Sujatha et al J Clin Gynecol Obstet 2012;1(1):15-18
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