EFFECT OF MATERNAL BODY MASS INDEX ON MATERNAL AND PERINATAL OUTCOME

Abstract

INTRODUCTION: India is a country with diverse people facing the burden of both under nourishment and over nourishment. Maternal malnourishment and over nourishment affects more than 30% of population in India. It‘s the most common co-morbidity in pregnancy. Body mass index provides simple numeric measure of a person‘s fitness and nutrition. Enormous studies have observed that being underweight and overweight, predisposes women to complicated pregnancies. Amongst the many indices and predictors of nutritional status of a person like Waist circumference (WC), waist to height ratio (WHtR), Abdominal volume index (AVI), Conicity Index (CI), underwater weighing, Dexa densitometry and BMI( Body mass index), BMI is the most acceptable index for determining the nutritional status. This study will help in bridging the gap in lack of knowledge among the rural antenatal population regarding the importance of nutrition and diet during the antenatal period. BMI assessment and correction of Abnormal BMI in pre-conceptional period improves the Obstetric prognosis and decreases the chances of mortality and morbidity in both the mother and her baby. This study is essential in reducing the burden of maternal and perinatal complication due to nutritional imbalance to a great extent. AIMS AND OBJECTIVES: 1. To assess the risk factors of abnormal BMI in pregnant women. 2. To evaluate the effect of BMI on maternal and perinatal outcome. METHODOLOGY: In this prospective observational study, 87 Antenatal women with period of gestation more than 28 weeks to 42 weeks, were selected and categorized into underweight, normal weight xix and overweight according to pre-pregnancy BMI considering the inclusion and exclusion criteria and were assessed for the risk factors that they developed during the antenatal period and the eventual maternal and perinatal outcome. The outcomes were recorded and tabulated. The results were statistically analysed using chi-square test, test for significance, mean and median. RESULTS: There was significant difference between the three groups in the risk factors they developed during the antenatal period (p= 0.041) , onset of labour (0.022), mode of delivery(0.002) and perinatal outcome(0.002), post partum complications (0.001)in mother and perinatal complications (0.004) in the baby. Antenatal risk factors were more prevalent in overweight women than in underweight and normal weight women. The most common risk factors developed during antenatal period in overweight women are pre ecclampsia and ante partum ecclampsia and in underweight women are anaemia and preterm labour. Adverse maternal outcome like increased rate of caesarean section and post partum ecclampsia were more commonly seen in overweight women and increased rate assisted/instrumental vaginal delivery and post partum haemorrhage were more commonly seen in underweight women. Babies born to overweight mothers had the highest rate of NICU admissions while the babies born to underweight mothers has the highest incidence of perinatal mortality and IUDs. CONCLUSION: Both maternal under weight and overweight has adverse pregnancy outcomes. Therefore, preconceptional stabilisation of body mass index is essential for having a healthy mother and baby. xx Antenatal counselling regarding nutrition, importance of healthy diet with customised diet chart should be prescribed for underweight women .weight reduction and normalising BMI during pre conceptional period in overweight women helps in reducing adverse pregnancy outcomes.