EFFECT OF MATERNAL BODY MASS INDEX ON THE MODE OF DELIVERY AND NEONATAL OUTCOME: A TERTIARY CARE HOSPITAL BASED STUDY IN SOLAN, HIMACHAL PRADESH.

Abstract

INTRODUCTION: Obesity is a global health problem characterised as a pandemic issue by the World Health Organization (WHO), with a higher prevalence in females than males. During pregnancy, it is considered a high-risk state because it is associated with maternal complications like preeclampsia, gestational diabetes, obstetric interventions like caesarean delivery, postpartum haemorrhage; and fetal complications like macrosomia, poor apgar scores. BMI is a commonly used indicator which can be used to classify subjects on the basis of weight.AIM: This study aims to find the prevalence of normal weight, overweight and obese pregnant women defined by body mass index (BMI) according to the WHO classification and to study the associations between maternal BMI, the mode of delivery and neonatal outcome.MATERIAL AND METHODS: 200 pregnant women admitted for delivery in the department of Obstetrics & Gynaecology were studied, height and weight were recorded from reliable antenatal records (recorded within two months of gestation). The Body Mass Index was calculated and patients were divided into four categories: Category I: underweight; Category II: normal BMI; Category III: Overweight; Category IV: Obese. The feto-maternal outcomes were studied.RESULTS: On evaluation of 200 nulliparous antenatal women with singleton term gestation, 1.5% were underweight, 33% had normal BMI, 56% were overweight and 9.5% were obese. The prolongation of labour was seen in subjects with BMI more than 25 kg/m2. Overweight patients had more instrumental deliveries and obese patients had a higher tendency for prolonged labour and caesarean deliveries. Neonatal outcomes were poor for obese and overweight patients as compared to normal BMI because more neonates required resuscitation at birth, had low Apgar scores and were small for gestational age. Maternal complications like Hypothyroidism, preeclampsia and gestational diabetes occurred more commonly in the obese category.CONCLUSION: In our institution, majority of patients were found to be overweight. Adverse perinatal outcomes were seen more often in the obese patients. Hence, obesity must be identified as a risk factor for adverse pregnancy outcomes.