Pregnancy outcome according to body mass index in primigravidas: a prospective cohort study

Nahla W. Shady, Department of Obstetrics & Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt
Hany F. Sallam, Department of Obstetrics & Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt
Shymaa S. Ali, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt
Ahmed M. Abbas, Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt

Abstract

Objective: The study aims to evaluate the association between Body Mass Index (BMI), gestational weight gain (GWG) and adverse obstetric outcomes among primigravidas.

Material and methods: This was a prospective cohort study conducted at a tertiary University Hospital between June 2015 and May 2017. The study included 480 primigravidas, with singleton pregnancies, who were divided into three groups: women with a healthy weight (BMI: 18.5–24.9 kg/m2) overweight (BMI: 25 – 29.9 kg/m2) and obese (BMI ≥ 30 kg/m2). The primary outcome of the study was the rate of GWG in the participants. Secondary outcomes included the rate of gestational diabetes mellitus (GDM), gestational hypertension, pre-eclampsia, preterm labor (PTL), postdate pregnancy, fetal macrosomia and the rate of birth by cesarean (CB).

Results: There were no significant differences between groups regarding the socio-demographic criteria. The rate of GWG was significantly higher in obese women versus average weight women (11.4±1.73 vs. 10.49±1.09, p=0.0001). There was an increased incidence of GDM (p=0.008), gestational hypertension (p=0.001), pre-eclampsia (p=0.0001), PTL (p=0.002), postdate (p=0.0001) and macrosomia (p=0.0001) in women who were obese compared with women with a healthy weight. Additionally, there was an increased incidence of CB with increasing body mass (p=0.0001)

Conclusions: Higher BMI in primigravidas is associated with increased GWG and with adverse pregnancy outcomes such as GDM, gestational hypertension, pre-eclampsia, PTL, postdate, fetal macrosomia and cesarean birth.

 

URL

https://ir.uiowa.edu/pog_in_press/90