ISSN No. 1606-7754                   Vol.16 No.2  August 2008

Maternal BMI and antenatal weight gain as determinants of obstetric outcome
C. Savona-Ventura, S Grima, K Vella
Department of Obstetrics & Gynaecology, Mater Dei University Hospital, Malta

Abstract

Obesity during pregnancy has been shown to carry significant risk to both mother and child. The role of uncontrolled weight gain during pregnancy has not been fully elucidated. The study analysed the incidence of gestational hypertension and fetal macrosomia in various groups of mothers according to their BMI and antenatal weight gain. A definite statistically significant increased risk of both gestational hypertension and infant macrosomia was demonstrated with increasing BMI. This was compounded by increases in antenatal birth weight in all ranges of maternal BMI suggesting that adverse maternal metabolic parameters may contribute towards promoting the development of maternal and fetal complications. A restricted calorific intake in obese individuals during pregnancy may contribute towards decreasing the relative risks to both mother and child.

Key words: Anthropomorphy, fetal complications, macrosomia

Introduction

The obese pregnant woman has been shown to have specific increased perinatal risks to mother and child. The fetal consequences of maternal obesity include excessive weight in the child.1 The macrosomic infant has been shown to carry short-term consequences in the form of birth trauma to the infant.2 Long-term consequences include the increased predisposition to develop Type 2 diabetes later on in life.3 The pathophysiology behind the development of macrosomia may be attributable to a genetic predisposition towards obesity reflected by the maternal anthropometry and/or to intrauterine overfeeding especially in the presence of altered carbohydrate metabolism. This study sets out to investigate the role of antepartum weight gain reflecting nutritional intake on the development of macrosomia, irrespective of any possible genetic predisposition towards obesity.

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