The Influence of Maternal Weight During Pregnancy on the Mode of Delivery: A Comprehensive Study

Author(s): Dr. Varsha Ojha, Dr. Archana Singh

Background:

Pre-pregnancy BMI has risen, especially in developed countries. Pre-pregnancy obesity (BMI > 25 kg/m²) affects up to 30% of pregnancies, with rates varying regionally. Excessive gestational weight gain (GWG) is defined as surpassing Institute of Medicine guidelines. Being obese before or during pregnancy raises the risk of developing gestational diabetes, hypertension, preeclampsia, and cesarean sections. Proper maternal weight management is crucial to minimize adverse perinatal outcomes and lasting health issues for both the mother and baby.

Aim of the study:

This study aims to investigate the relationship between maternal weight during pregnancy and the mode of delivery, highlighting the importance of proper weight management to mitigate adverse outcomes.

Methods:

This retrospective study at Prime Hospital, Dubai, included 1000 pregnant women over ten years from 2012 to 2024, with informed consent. Inclusion criteria: 18 to 35 years old, documented pre-pregnancy BMI, 37 to 40 weeks of gestation, cephalic presentation, and absence of anomalies. Exclusion criteria: missing maternal height/weight records, congenital malformations, antepartum hemorrhage, and factors causing adverse outcomes (e.g., smoking). Participants' BMI was classified as normal, overweight, or obese based on their BMI before pregnancy and at the time of delivery. Data collection involved history, clinical exams, ultrasounds, and routine tests. Outcomes included delivery methods, fetal health assessed by Apgar scores, and NICU needs. Statistical analysis used SPSS, with significance at P<0.05.

Result:

The study involved 1000 women, mostly younger than 30 years (54.5%) and with high parity (61% had more than two previous births). Most pregnancies were full-term (95.2%). Regarding gestational weight gain, 24.8% had inadequate, 42.3% had adequate, and 32.9% had excessive weight gain. BMI-influenced outcomes: Obese women had more preterm deliveries (6.62%) and caesarean sections (40.07%) compared to normal BMI women. Birth weights varied with BMI: low birth weight was slightly more common in obese women, while macrosomia was highest in obese women (15.33%). Apgar scores were lower in higher BMI groups, and NICU admissions and neonatal mortality rates were slightly higher in obese women.

Conclusion:

The study associates excessive maternal weight gain and elevated pre-pregnancy BMI with a higher rate of cesarean deliveries. Obese women have the highest cesarean rates and adverse fetal outcomes like macrosomia, lower Apgar scores, and higher NICU admissions. Proper weight management during pregnancy is crucial to reducing delivery complications and improving health outcomes.