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, Inhaltsverzeichnis

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

Authors

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

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

Volltext

Referenzen

References
1 World Health Organization. Obesity and overweight fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/ . Accessed March 23, 2017
2 World Health Organization. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser 2003; 916: 1-149
3 Ng M, Fleming T, Robinson M. , et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384 (9945): 766-781
4 Balarajan Y, Villamor E. Nationally representative surveys show recent increases in the prevalence of overweight and obesity among women of reproductive age in Bangladesh, Nepal, and India. J Nutr 2009; 139 (11) 2139-2144
5 Villamor E, Msamanga G, Urassa W. , et al. Trends in obesity, underweight, and wasting among women attending prenatal clinics in urban Tanzania, 1995-2004. Am J Clin Nutr 2006; 83 (06) 1387-1394
6 Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 2001; 91 (03) 436-440
7 Cnattingius S, Bergström R, Lipworth L, Kramer MS. Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998; 338 (03) 147-152
8 Jensen DM, Damm P, Sørensen B. , et al. Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant Danish women. Am J Obstet Gynecol 2003; 189 (01) 239-244
9 Sebire NJ, Jolly M, Harris JP. , et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 2001; 25 (08) 1175-1182
10 Stephansson O, Dickman PW, Johansson A, Cnattingius S. Maternal weight, pregnancy weight gain, and the risk of antepartum stillbirth. Am J Obstet Gynecol 2001; 184 (03) 463-469
11 Young TK, Woodmansee B. Factors that are associated with cesarean delivery in a large private practice: the importance of prepregnancy body mass index and weight gain. Am J Obstet Gynecol 2002; 187 (02) 312-318
12 Marshal MP, Burton CM, Chisolm DJ, Sucato GS, Friedman MS. Cross-sectional evidence for a stress-negative affect pathway to substance use among sexual minority girls. Clin Transl Sci 2013; 6 (04) 321-322
13 Chisolm MS. Advancing education in psychiatry. Int Rev Psychiatry 2013; 25 (03) 253-254
14 United States Department of Health and Human Services. National Institutes of Health. Global Network for Women's and Children's Health Research. Available at: https://www.nichd.nih.gov/research/supported/Pages/globalnetwork.aspx . Accessed April 3, 2017
15 Koso-Thomas M, McClure EM. ; Global Network for Women's and Children's Health Research Investigators. The global network for women's and children's health research: a model of capacity-building research. Semin Fetal Neonatal Med 2015; 20 (05) 293-299
16 Global Network for Women's & Children's Health Research. Available at: https://globalnetwork.azurewebsites.net/Research-Studies/Active-Studies/MNH . Accessed April 3, 2017
17 Goudar SS, Carlo WA, McClure EM. , et al. The maternal and newborn health registry study of the global network for women's and children's health research. Int J Gynaecol Obstet 2012; 118 (03) 190-193
18 Bose CL, Bauserman M, Goldenberg RL. , et al. The global network maternal newborn health registry: a multi-national, community-based registry of pregnancy outcomes. Reprod Health 2015; 12 (Suppl. 02) S1
19 World Health Organization. BMI classification. Available at: http://apps.who.int/bmi/index.jsp?introPage=intro_3.html . Accessed February 15, 2017
20 Amercian College of Obstetrics and Gynecology. Preeclampsia and High Blood Pressure During Pregnancy. Available at: http://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy#hypertension . Accessed March 23, 2017
21 Allen VM, Joseph K, Murphy KE, Magee LA, Ohlsson A. The effect of hypertensive disorders in pregnancy on small for gestational age and stillbirth: a population based study. BMC Pregnancy Childbirth 2004; 4 (01) 17
22 Chu SY, Kim SY, Schmid CH. , et al. Maternal obesity and risk of cesarean delivery: a meta-analysis. Obes Rev 2007; 8 (05) 385-394
23 Ehrenberg HM, Dierker L, Milluzzi C, Mercer BM. Prevalence of maternal obesity in an urban center. Am J Obstet Gynecol 2002; 187 (05) 1189-1193
24 Flenady V, Koopmans L, Middleton P. , et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet 2011; 377 (9774): 1331-1340
25 Meehan S, Beck CR, Mair-Jenkins J, Leonardi-Bee J, Puleston R. Maternal obesity and infant mortality: a meta-analysis. Pediatrics 2014; 133 (05) 863-871
26 Khan MN, Rahman MM, Shariff AA, Rahman MM, Rahman MS, Rahman MA. Maternal undernutrition and excessive body weight and risk of birth and health outcomes. Arch Public Health 2017; 75: 12
27 Nahar S, Rahman A, Nasreen HE. Factors influencing stillbirth in bangladesh: a case-control study. Paediatr Perinat Epidemiol 2013; 27 (02) 158-164
28 Kusiako T, Ronsmans C, Van der Paal L. Perinatal mortality attributable to complications of childbirth in Matlab, Bangladesh. Bull World Health Organ 2000; 78 (05) 621-627
29 Saereeporncharenkul K. Correlation of BMI to pregnancy outcomes in Thai women delivered in Rajavithi Hospital. J Med Assoc Thai 2011; 94 (Suppl. 02) S52-S58
30 Rahman MM, Abe SK, Kanda M. , et al. Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis. Obes Rev 2015; 16 (09) 758-770
31 Kaslow NJ, Thompson MP, Okun A. , et al. Risk and protective factors for suicidal behavior in abused African American women. J Consult Clin Psychol 2002; 70 (02) 311-319
32 Baig-Ansari N, Badruddin SH, Karmaliani R. , et al. Anemia prevalence and risk factors in pregnant women in an urban area of Pakistan. Food Nutr Bull 2008; 29 (02) 132-139