RELATIONSHIP OF MATERNAL MORBIDITY AND MORTALITY TO HIGH BODY MASS INDEX (BMI) PREGNANCIES IN PAKISTAN.

BACKGROUND

The average BMI is shifting upwards even in low-resource countries like Pakistan causing an increase in pregnancy-related complications. This study was planned to elaborate the association of maternal morbidity and mortality during pregnancy and puerperium with high BMI.

METHODS

A descriptive longitudinal study was performed in the Obstetrics and Gynaecology Unit 2 of D. Ruth K. M. Pfau Civil Hospital, Karachi, Pakistan from 1st August 2022 to 31st January 2023. Women delivering in Obstetric Unit 2 having a 1st-trimester record of weight were included. Demographic data, antenatal, intrapartum and postpartum complications noted. Participants were further stratified into 2 groups based on BMI, i.e., overweight (25.0-29.9) and obese (30.0 or more) and demographics and clinical characteristics compared. Univariate and multivariate logistic regression analysis was done. Data was entered and analyzed on SPSS version 21.

RESULTS

The frequency is calculated to be 15.7%. The observed complications included pre-eclampsia 16.7%, PIH 13%, eclampsia 7%, GDM 18.9%, induction of labour 19.5%, PPH in 15.2% and infected caesarean wound in 19.2% of participants. The caesarean section was the predominant mode of delivery in 55.7%. A significant relationship was found with advancing maternal age, DM/ GDM, hypertension, Pre-eclampsia, IOL, caesarean section, PPH and wound infection. The univariate and multivariate logistic regression models also showed two times higher odd in obese groups as compared to overweight groups.

CONCLUSIONS

Our study underscores a strong association between maternal obesity in early pregnancy and several threatening complications during pregnancy, delivery, and the postpartum period.