Dr Sheba Meriam Thomas1, Dr Asha Mathai1, Dr Anuja Abraham1, Dr Manisha Madhai Beck1, Dr Swathi Rathore1, Dr Sudha Jasmine Rajan1
1Christian Medical College, Vellore, India
Biography:
Dr. Sheba Meriam Thomas, completed her MD in Medicine in 2016 and is an Assistant Professor of Medicine at Christian Medical College, Vellore, India. Her areas of interest include Obstetric medicine, especially Infections in pregnancy. She is actively involved in undergraduate and post graduate education.
Abstract:
Obesity in Pregnancy is a cause of maternal and foetal morbidity and mortality (1). After informed consent, this prospective cohort recruited consecutive antenatal, singleton women in the first trimester. The baseline body mass Index (BMI), Knowledge Attitude, and Practice (KAP) towards nutrition in pregnancy and the physical activity Index questionnaire were administered. Incidence of Gestational Hypertension (GHTN), Gestational Diabetes Mellitus (GDM), mode of delivery, and foetal outcomes were assessed. A sample size of 292 was calculated with 80% power and 5% alpha, assuming obesity is 2 times more likely to cause GHTN and GDM. 293 pregnant women were recruited, 27%(n=79) and 11.9%(n=35) were overweight and obese, respectively. The incidence of GDM was 36.7%(n=29) in the overweight and 60%(n=21) in the obese group as compared to 28.7% (n=43) among normal BMI group with an odds ratio of 2.036(95% CI 1.24-3.34, P=0.004) of developing GDM if overweight/obese. Incidence of PIH was 8.9%(n=7) in the overweight and 20%(n=7) in the obese versus 4.7%(n=7) in the normal BMI category and the odds ratio was 2.99(95%CI 1.21-7.38, p=0.017) of PIH in the obese/overweight category. Maternal complications during delivery were significantly higher in the overweight and obese group (36.8%and 34.3%) as compared to 25% in the normal BMI group. The mean birth weight increased linearly with maternal BMI,3.1 kg in the obese and 2.89 Kg with normal BMI. The KAP questionnaire showed a similar understanding regarding healthy dietary practices (94.9 Vs 93.4%) in the overweight and normal BMI group. On evaluation of the physical activity index,70.1 % (n=25) of the obese group had a sedentary lifestyle. The limitation of this study was that subsequent weight gains during the pregnancy were not assessed. A higher baseline BMI doubles the risk for GHTN and GDM. Early intervention, lifestyle modification among overweight/obese young women will reduce the risk for GHTN and GDM.
Keywords
"Obesity", "BMI", "GDM", "PIH"
References
1. Langley‐Evans SC, Pearce J, Ellis S. Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review. J Hum Nutr Diet. 2022 Apr;35(2):250–64.