The effects of maternal body mass index (BMI) on the pregnancy outcome among primigravida who delivered at Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang
Objective: To measure the prevalence of maternal and fetus/ newborn complications during antenatal, intrapartum and postpartum periods and the intrapregnancy weight gain for each BMI category. Methods: This is a cohort study between December 2011 and November 2012. The study includes all primig...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier Ireland Ltd.
2012
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/29263/ http://irep.iium.edu.my/29263/ http://irep.iium.edu.my/29263/ http://irep.iium.edu.my/29263/1/The_effects_of_maternal_body-.pdf |
| Summary: | Objective: To measure the prevalence of maternal and fetus/
newborn complications during antenatal, intrapartum and
postpartum periods and the intrapregnancy weight gain for each
BMI category.
Methods: This is a cohort study between December 2011 and
November 2012. The study includes all primigravida who booked
before 14 weeks of gestation. Upon delivery women had their
antenatal, intrapartum and postpartum events reviewed and then
categorized into five BMI groups; underweight (£19.9 kg/m2),
normal (20–24.9 kg/m2), overweight (25–29.9 kg/m2), obese (30–
34.9 kg/m2) and morbidly obese (>35 kg/m2). Women were
followed up until discharged and reviewed again at 6 weeks
postpartum. All statistical analyses were performed with the use of
SPSS for Windows, version 18.0 (SPSS) and P value of <0.05 was
taken to be statistical significant.
Results: A total of 102 women were enrolled. There were 29
(28.4%) underweight, 36 (35.2%) normal weight, 14 (13.7%)
overweight, 19 (18.6%) obese and 3 (2.9%) morbidly obese
women. The mean age was 26 years (SD 4.0) and the majorities
were Malays (90.2%). The morbidly obese group was found to
experience higher percentage of gestational diabetes mellitus
(33%), pregnancy induced hypertension (100%), preterm delivery
(33%), augmentation (100%) and instrumentation (33%). Risk of
caesarean section was highest (64%) in the overweight group.
Highest risk of shoulder dystocia (33%) and wound dehiscence
(15.8%) were observed in the obese group. The underweight
women had higher risk for preterm delivery (17%). The mean
intrapregnancy weight gain for each BMI category
were:12.2 ± 4.6 kg (underweight), 13.6 ± 4.4 kg (normal),
12.8 ± 5.5 kg (overweight), 12.4 ± 6.2 kg (obese) and 0.8 ± 7.8 kg
(morbidly obese). Morbidly obese group had lower intrapregnancy
weight gain compared to other groups (P = 0.004).
Conclusion: The maternal risk increases as the BMI increases
whereas the fetal risk increases with the extreme of BMI
(underweight and morbidly obese). Inappropriate weight gain was
observed in all groups but was significant in the morbidly obese. |
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