Naik Rini, Karmali Deepa, Nagarsenkar Ajit, Mainath Sneha, Pednekar Guruprasad
Department of Obstetrics and Gynaecology, Goa Medical College, Bambolim, Goa India.
J Obstet Gynaecol India. 2022 Apr;72(2):141-146. doi: 10.1007/s13224-021-01565-z. Epub 2021 Sep 23.
Maternal body mass index (BMI) is a vital predictor of the nutritional status of any pregnant woman. Several developing countries like India are facing the double burden of both obesity and malnutrition due the extreme socioeconomic distribution of our population. Thus, this study was undertaken to study the effect of pre-pregnancy maternal BMI on the obstetric outcomes.
A retrospective observational study was conducted during the time period of 1 year (December 2018-December 2019), wherein we analysed 3940 women who delivered in Goa Medical College. Depending on the maternal BMI calculated at the first antenatal visit, all the study participants were divided into five BMI groups and their obstetric outcomes were studied.
Majority of the study participants were in the normal BMI category (49.8%); however, a large number of women were overweight (37.3%), 3.2% were obese, 0.1% were morbidly obese, and 9.6%were underweight. Antenatal complications like anaemia and IUGR were more common in underweight women, whereas pre-eclampsia, GDM, macrosomia, antepartum haemorrhage and preterm labour were more common in obese women. Increased rate of Caesarean sections and postpartum complications like PPH, wound sepsis and puerperal sepsis were observed in overweight and obese women.
Thus, adverse obstetric outcomes were observed in extremes of maternal BMI. Hence, there is a need to provide pre-conception counselling to all women in the reproductive age group so that they can achieve normal BMI prior to conception and thus reduce maternal morbidity and mortality rates in our country.
孕妇体重指数(BMI)是任何孕妇营养状况的重要预测指标。像印度这样的几个发展中国家,由于人口极端的社会经济分布,正面临肥胖和营养不良的双重负担。因此,本研究旨在探讨孕前孕妇BMI对产科结局的影响。
在1年时间内(2018年12月至2019年12月)进行了一项回顾性观察研究,我们分析了在果阿医学院分娩的3940名妇女。根据首次产前检查时计算的孕妇BMI,将所有研究参与者分为五个BMI组,并研究其产科结局。
大多数研究参与者属于正常BMI类别(49.8%);然而,大量妇女超重(37.3%),3.2%肥胖,0.1%病态肥胖,9.6%体重不足。贫血和胎儿生长受限等产前并发症在体重不足的妇女中更为常见,而子痫前期、妊娠期糖尿病、巨大儿、产前出血和早产在肥胖妇女中更为常见。超重和肥胖妇女剖宫产率增加,产后并发症如产后出血、伤口感染和产褥感染也增加。
因此,在孕妇BMI极端情况下观察到不良产科结局。因此,有必要为所有育龄妇女提供孕前咨询,以便她们在怀孕前达到正常BMI,从而降低我国孕产妇发病率和死亡率。