According to the World Health Organization (WHO), obesity is one of the most significant global health issues of the  21st century due to the alarming rise in prevalence 1.Abnormal Body mass index (BMI) during pregnancy is a growing public health concern as it has been associated with an increased risk of maternal and neonatal complications.

Maternal risks associated with obesity include gestational diabetes mellitus (GDM), gestational hypertension (GHT), intrapartum complications, and postpartum complications 2.Fetal risks associated with obesity include birth abnormalities, macrosomia, unexplained stillbirths, admission to the neonatal intensive care unit (NICU), and neonatal fatalities 2.

This study aimed to investigate the impact of abnormal (low & high) BMI on maternal and neonatal outcomes compared to normal BMI.

 

Methodology

This is a retrospective cohort study that included 14,624 singleton births in a tertiary maternity hospital in Qatar over a 12-month period.

Women were categorized based on WHO BMI classification as underweight (BMI <18.5 kg/m2), overweight (25.0-29.9 kg/m2), obesity class I (30.0– 34.9 kg/m2), obesity class II (35.0– 39.9 kg/m2), and obesity class III (≥40.0 kg/m2) and compared to women with normal BMI (18.5-24.9 kg/m2)

Outcomes included GDM, GHT, postpartum hemorrhage (PPH), cesarean delivery (CD), preterm birth (PTB), low birth weight (LBW), congenital anomalies, and NICU admission.

 

Results

Being underweight during pregnancy was associated with an increased risk of PTB (aOR 2.09, 95% CI 1.37-3.20, p=0.001), LBW (OR 1.88, 95% CI 1.27-2.79, p=0.002) and congenital anomalies (aOR 2.52 95% CI 1.12-5.64, p=0.025).

Nearly 67% in the underweight group had less than average expected weight gain, compared to the 56% in the normal BMI group and 45-46% in the obesity II & III groups.

Conclusion