The Relationship between Body Mass Index in Pregnancy and Adverse Maternal, Perinatal, and Neonatal Outcomes in Rural India and Pakistan

Vanessa L. Short; Stacie E. Geller; Janet L. Moore; Elizabeth M. McClure; Shivaprasad S. Goudar; Sangappa M. Dhaded; Bhalachandra S. Kodkany; Sarah Saleem; Farnaz Naqvi; Omrana Pasha; Robert L. Goldenberg; Archana B. Patel; Patricia L. Hibberd; Ana L. Garces; Marion Koso-Thomas; Menachem Miodovnik; Dennis D. Wallace; Richard J. Derman

doi:10.1055/s-0037-1621733

American Journal of Perinatology, Table of Contents

Am J Perinatol 2018; 35(09): 844-851
DOI: 10.1055/s-0037-1621733

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Relationship between Body Mass Index in Pregnancy and Adverse Maternal, Perinatal, and Neonatal Outcomes in Rural India and Pakistan

Vanessa L. Short

¹Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania

,

Stacie E. Geller

²Center for Research on Women and Gender, University of Illinois, Chicago, Illinois

,

Janet L. Moore

³Social, Statistical, and Environmental Health Sciences, RTI International, Durham, North Carolina

,

Elizabeth M. McClure

³Social, Statistical, and Environmental Health Sciences, RTI International, Durham, North Carolina

,

Shivaprasad S. Goudar

⁴Jawaharlal Nehru Medical College, KLE University, Belgaum, Karnataka, India

,

Sangappa M. Dhaded

⁴Jawaharlal Nehru Medical College, KLE University, Belgaum, Karnataka, India

,

Bhalachandra S. Kodkany

⁴Jawaharlal Nehru Medical College, KLE University, Belgaum, Karnataka, India

,

Sarah Saleem

⁵Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

,

Farnaz Naqvi

⁵Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

,

Omrana Pasha

⁵Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

,

Robert L. Goldenberg

⁶Department of Obstetrics and Gynecology, Columbia University Medical School, New York, New York

,

Archana B. Patel

⁷Lata Medical Research Foundation, Nagpur, Maharashtra, India

,

Patricia L. Hibberd

⁸School of Public Health, Boston University, Boston, Massachusetts

,

Ana L. Garces

⁹Instituto de Nutricion de Centroamerica y Panama, Guatemala City, Guatemala

,

Marion Koso-Thomas

¹⁰Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland

,

Menachem Miodovnik

¹⁰Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland

,

Dennis D. Wallace

³Social, Statistical, and Environmental Health Sciences, RTI International, Durham, North Carolina

,

Richard J. Derman

¹Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania

› Author Affiliations

Abstract

Objective The objective of this study was to describe the relationship between early pregnancy body mass index (BMI) and maternal, perinatal, and neonatal outcomes in rural India and Pakistan.

Study Design In a prospective, population-based pregnancy registry implemented in communities in Thatta, Pakistan and Nagpur and Belagavi, India, we obtained women's BMI prior to 12 weeks' gestation (categorized as underweight, normal, overweight, and obese following World Health Organization criteria). Outcomes were assessed 42 days postpartum.

Results The proportion of women with an adverse maternal outcome increased with increasing maternal BMI. Less than one-third of nonoverweight/nonobese women, 47.2% of overweight women, and 56.0% of obese women experienced an adverse maternal outcome. After controlling for site, maternal age and parity, risks of hypertensive disease/severe preeclampsia/eclampsia, cesarean/assisted delivery, and antibiotic use were higher among women with higher BMIs. Overweight women also had significantly higher risk of perinatal and early neonatal mortality compared with underweight/normal BMI women. Overweight women had a significantly higher perinatal mortality rate.

Conclusion High BMI in early pregnancy was associated with increased risk of adverse maternal, perinatal, and neonatal outcomes in rural India and Pakistan. These findings present an opportunity to inform efforts for women to optimize weight prior to conception to improve pregnancy outcomes.

Keywords

body mass index - Asia - perinatal mortality - global health

Full Text

References

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