Publication:

Impact of maternal pre-pregnancy body mass index on neonatal outcomes: a hospital based study in a tertiary care hospital in Goa

Background Maternal under-nutrition as well as obesity, both are known to have adverse effects on the perinatal outcomes. In developing countries like India wherein the burden of both under-nutrition and obesity is rising, there is a need to spread awareness regarding the need to achieve adequate weight prior to pregnancy. Thus, this study was undertaken to observe effect of maternal pre-pregnancy BMI on neonatal outcomes in Goa Medical College (GMC) during the time period from December 2018- December 2019.

Methods A hospital based retrospective observational study was conducted wherein the neonatal outcomes of 3940 women delivering in Goa Medical College during the time period of 1 year were studied. All the study participants were divided into five groups depending upon their BMI calculated at the first antenatal visit in the first trimester.

Results Most of the women in our study were in the normal BMI category (49.8%), however a large number were overweight (37.3%), 3.2% were obese and 0.1% were morbidly obese and 9.6%were underweight. The neonates born to underweight mothers were mostly low birth weight (66.6%) while macrosomia was more common in those born to obese (3.1%) and morbidly obese (25%) women. Neonatal complications like birth asphyxia, respiratory distress syndrome and hypoglycaemia were found in significantly higher proportion in both underweight as well as obese groups. These complications were responsible for a higher NICU admission rate and a higher neonatal mortality observed in both underweight as well obese group of mothers.

Conclusions Thus in view of the poor neonatal outcomes observed in both extremes of maternal BMI, it is the need of the hour to establish better nutrition programs and educate our women regarding the necessity to achieve adequate pre-pregnancy BMI to improve the pregnancy outcomes.