Association of The Pre-Pregnancy Body Mass Index and Gestational Weight Gain With Pregnancy Outcomes in Pregnant Women in Ahmedabad in Gujarat Region

Abstract

Background: The effect of maternal pre-pregnancy Body Mass Index (BMI) and Gestational Weight Gain (GWG) on various pregnancy outcomes such as Gestationla Diabetes Mellitus (GDM), pregnancy-induced hypertension, caesarean delivery, preterm delivery, Large for Gestational Age (LGA), Small for Gestational Age (SGA) is very important to study. Objective: To evaluate the prevalence, GWG, various pregnancy outcomes of underweight, overweight or obese pregnant women, and to study the correlation between Pre-pregnancy BMI as well as GWG during pregnancy and adverse pregnancy outcomes. Study Methodology: This is a prospective, multi-centric study involving pregnant women with gestation week ≤ 20 weeks in Ahmedabad in Gujarat region. Results: Our study observed that out of 226 women enrolled, 44 women (19.47%) were underweight, 137 women (60.62%) were normal, 30 women (13.27%) were overweight and 15 women (6.64%) were obese. The incidence of caesarean delivery (56.92%) was found more in nuclear family as compared to joint family (46.92%). In upper socio-economic class, the incidence of pre-tem delivery was found 54.54%, and the rest of 45.54% had full-term delivery. A partial negative correlation (r= -0.116) was observed between socioeconomic status and term of delivery. It was observed from the study that the frequency of normal delivery was lower in upper class compared to lower socio-economic class. A partial positive correlation (r= 0.177), thus is obtained between socio-economic class and type of delivery. The incidence of caesarean delivery (56.92%) was more in nuclear family as compared to joint family (46.92%). A fractional positive correlation (r= 0.16) is observed between type of family and type of delivery. In present study we compared type of previous delivery(ies) to type of present delivery. It was observed that the risk of caesarean section delivery was more in women who had previous history of caesarean section. It was discovered that in women who had no history of abortion/miscarriage, 54.44% had normal delivery and 44.97% and 0.59% had caesarean section and forcep type of delivery respectively In women who had 1 glass milk daily, the incidence of Low Birth Weight (LBW) infant was 20.62%, normal birth weight was 75.26% and High Birth Weight (HBW) was 4.12%. In women who had atleast 1 fruit the chances of LBW (19.32%) was comparatively low compared to them who had no milk at all. It was found that in women taking no junk food at all, the chances of LBW were 16.39%, which was less compared to mothers who had junk food. Present study spotted decrease in risk of caesarean delivery with increase in maternal haemoglobin level from 9.0Institute of Pharmacy, Nirma University Page 2 gm/dl till 12.0 gm/dl. Average weight gain observed in underweight was 12.93 ± 1.90, in normal 12.32 ± 1.71, in overweight 10.23 ± 1.28 and in obese 9.6 ± 1.50. A negative correlation was found between GWG and pre-pregnancy BMI, i.e. as pre-pregnancy BMI increase, the GWG decrease. The incidence of pre-term delivery (9.49%) was much less in normal BMI range. The average infant birth weight observed in underweight women was 2.63 ± 0.47, in normal was 2.9 ± 0.49, in overweight was 2.92 ± 0.56 and in obese was 2.95 ± 0.86. It is observed that highest birth weight is obtained in obese women, which decreases as the maternal BMI range decreases. The incidence of LBW in normal and overweight women was 15.33 and 16.67%, which was low as compared to obese and underweight women.Conclusion: Our study reveals that parameters such as GWG, type of family, intake of milk, fruits and junk food, directly affects the pregnancy outcomes such as term of delivery, type of delivery and infant birth weight. As pre-pregnancy BMI increases, term of delivery decreases and the GWG decreases As GWG decreases, the infant birth weight decreases. Present study found that the incidence of LBW and HBW was more in obese women compared to women with normal or underweight BMI.