THE HEAVY TOLL: ASSOCIATION OF MATERNAL OBESITY WITH FETOMATERNAL OUTCOMES– A CROSS-SECTIONAL STUDY IN KASHMIR
Main Article Content
Keywords
OBESITY, , body mass index (BMI), Pregnancy Induced Hypertension (PIH), Adverse fetomaternal outcomes, Gestational diabetes mellitus
Abstract
Obesity, a chronic disease recognised by WHO, is rising globally and linked to adverse maternal and neonatal outcomes. In pregnancy, it increases the risk of gestational diabetes, hypertension, caesarean delivery, wound infections, and NICU admissions. Despite its growing impact, Indian data are limited. This study aims to assess and compare the impact of maternal BMI on GDM, PIH, and IHCOP, mode of delivery, intrapartum complications, and neonatal outcomes like birth weight, APGAR score, and NICU admission in a tertiary care centre in Kashmir. A cross-sectional comparative study was conducted over 18 months at SKIMS, Srinagar, including 224 gravid singleton women meeting the inclusion criteria. Data were analysed using SPSS Version 20.0. Obese women (Group A) had higher rates of GDM (37.5% vs. 11.1%, p<0.001), PIH (34.6% vs. 16.7%, p=0.003), and IHCOP (30.8% vs. 18.5%, p=0.038). LSCS was more frequent (77.9% vs. 54.6%, p<0.001), with macrosomia and failed induction exclusive to this group. Preterm birth (<35 weeks) occurred in 12.5% vs. 2.8% (p=0.002). Neonates of obese mothers had higher birth weights (p<0.001), lower APGAR scores (<7: 23.6% vs. 10.7%, p=0.021), and greater NICU admissions (25% vs. 11.1%, p=0.008). Wound infections (13.6% vs. 3.4%, p=0.041) and shoulder dystocia (5.8%, p=0.013) were also more frequent. No significant differences were found in eclampsia, abruptio placentae, PPH, or stillbirth. Thus, maternal obesity is strongly associated with pregnancy complications and adverse neonatal outcomes, stressing the importance of early weight management and tailored interventions in low-resource settings.
References
2. World Health Organization. Obesity and overweight: fact sheet. Geneva: WHO; 2021 [cited 2025 Jul 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
3. Bentham J, Di Cesare M, Bilano V, et al. Worldwide trends in body-mass index from 1975 to 2016: a pooled analysis. Lancet. 2017;390(10113):2627–2642.
4. Kelly T, Yang W, Chen CS, et al. Global burden of obesity in 2005 and projections to 2030. Int J Obes. 2008;32(9):1431–1437.
5. Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short and long term adverse consequences. BMJ. 2017;356:j1. doi:10.1136/bmj.j1.
6. Sebire NJ, Jolly M, Harris JP, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies. Int J Obes. 2001;25(8):1175.
7. Kristensen J, Vestergaard M, Wisborg K, et al. Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG. 2005;112(4):403–8.
8. Tonidandel A, Booth J, D’Angelo R, et al. Anesthetic and obstetric outcomes in morbidly obese parturients. Int J Obstet Anesth. 2014;23(4):357–64.
9. Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004;103(2):219–24.
10. Lee KK, Raja EA, Lee AJ, et al. Maternal obesity during pregnancy and long-term cardiovascular risk. Hypertension. 2015;66(5):938–44.
11. Babu GR, Girish M, Murthy GVS, et al. Do gestational obesity and gestational diabetes have an independent effect on neonatal adiposity? Diabetes Res Clin Pract. 2019;149:171–183. doi:10.1016/j.diabres.2019.01.034.
12. International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-5), India, 2019–21: National Report. Mumbai: IIPS; 2021. Available from: https://www.rchiips.org/nfhs/NFHS-5Reports/NFHS-5_INDIA_REPORT.pdf
13. Deshmukh VL, Jadhav M, Yelikar K. Impact of high BMI on pregnancy: maternal and foetal outcome. J Obstet Gynaecol India. 2016;66(Suppl 1):192–7.
14. Jacob AT, Jacob S, George S, et al. Maternal obesity: pregnancy outcome among overweight and obese women in Kerala. Int J Clin Obstet Gynaecol. 2021;5(2):24–27.
15. Rokade J, Darekar Y. Fetomaternal outcome in obese pregnant females. Int J Sci Res. 2018;7(2):893–95.
16. Candeloro M, Di Nisio M, Ponzano A, et al. Effects of obesity and thrombophilia on the risk of abortion in women undergoing in vitro fertilization. Front Endocrinol (Lausanne). 2020;11:594867. doi:10.3389/fendo.2020.594867
17. Bellver J, Melo MAB, Bosch E, et al. Obesity and poor reproductive outcome: the potential role of the endometrium. Fertil Steril. 2003;79(6):1136–1139. doi:10.1016/S0015-0282(03)00319-4
18. Dasgupta A, Harichandrakumar KT, Habeebullah S. Pregnancy outcome among obese Indians: a prospective cohort study. Int J Sci Study. 2014;2(2):13–8.
19. Awan S, Bibi S, Makhdoom A, et al. Adverse fetomaternal outcomes in overweight women. Pak J Med Sci. 2015;31(2):383–387.
20. Sonagra AD, Biradar SM, Kodati D, et al. Normal pregnancy – a state of insulin resistance. J Clin Diagn Res. 2014;8(11):CC01–03. doi:10.7860/JCDR/2014/10068.5081
21. Seeniammal P, Chellamma VK, Umadevi NA. Effect of body mass index on pregnancy outcomes. Int J Reprod Contracept Obstet Gynecol. 2017;6:1550–54.
22. Vanlalfeli Z. Study of maternal and fetal outcome in obesity complicating pregnancy. Int J Contemp Med Res. 2020;7(2):B1–B5.
23. Gao XX, Ye MY, Liu Y, et al. Prevalence and risk factors of intrahepatic cholestasis of pregnancy in a Chinese population. Sci Rep. 2020;10(1):16307. doi:10.1038/s41598-020-73378-5
24. Kumari P, Malviya S, Gupta M, et al. Association between high maternal BMI and feto-maternal outcome. J Obes Metab Res. 2014;1:143–8.
25. Schrauwers C, Dekker G. Maternal and perinatal outcome in obese pregnant patients. J Matern Fetal Neonatal Med. 2009;22(3):218–26.
26. Usha Kiran TS, Hemmadi S, Bethel J, et al. Outcome of pregnancy in women with increased BMI. BJOG. 2005;112(6):768–72.
27. Butwick AJ, Abreo A, Bateman BT, et al. Effect of maternal BMI on postpartum hemorrhage after cesarean delivery. Anesthesiology. 2018;128(5):774–783. doi:10.1097/ALN.0000000000002230.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Sumaya Ramzan
Senior resident, Deptt. Of Obstetrics and Gynaecology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
Dr. Saima Wani
Associate Professor, Deptt. Of Obstetrics and Gynaecology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
Dr. Rabia Khursheed
Professor, Deptt. Of Obstetrics and Gynaecology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
Dr. Diksha Dadlani
Post-graduate scholar, Deptt. Of Obstetrics and Gynaecology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India