Year: 2026 | Month: July | Volume: 16 | Issue: 7 | Pages: 125-135
DOI: https://doi.org/10.52403/ijhsr.20260713
Association of Maternal Body Mass Index and Gestational Weight Gain on Maternal and Neonatal Outcomes
Pravinkumar Jadav1, Kruti Tanna2, Palak Dabhi3
1,2Department of Obstetrics and Gynecology, B.J. Medical College, Gujarat University, Ahmedabad, India.
3Department of Obstetrics and Gynecology, Sunrise Women’s Hospital, Ahmedabad
Corresponding Author: Dr. Pravinkumar Jadav
ABSTRACT
Introduction: Maternal body mass index (BMI) and gestational weight gain (GWG) are important determinants of pregnancy outcomes. Both maternal obesity and inappropriate GWG have been associated with increased maternal and neonatal morbidity. This study evaluated the independent and combined effects of maternal BMI and GWG on maternal and neonatal outcomes.
Material and Methods: A prospective observational cohort study was conducted among 400 singleton pregnancies at a tertiary care hospital. Maternal BMI was recorded at or before 14 weeks of gestation and categorized according to World Health Organization criteria as overweight or obese. GWG was classified as ideal, excessive, or inadequate according to Institute of Medicine recommendations. Maternal and neonatal outcomes were analyzed using Chi-square or Fisher's exact test. Crude relative risks (RRs) with 95% confidence intervals (CIs) were calculated, and p<0.05 was considered statistically significant.
Results: Of the 400 women, 330 (82.5%) were overweight and 70 (17.5%) were obese. Excessive GWG occurred in 71.4% of obese women compared with 33.3% of overweight women. In obese women, there were significantly increased the risk of cesarean delivery (50.0% vs. 24.8%; RR 2.01, 95% CI 1.49–2.71; p<0.001), operative vaginal delivery (18.6% vs. 8.8%; RR 2.12, 95% CI 1.18–3.82; p=0.01), low birth weight (45.7% vs. 26.4%; RR 1.73, 95% CI 1.24–2.41; p=0.001), and neonatal intensive care unit admission (58.6% vs. 35.2%; RR 1.66, 95% CI 1.28–2.16; p<0.001). Compared with ideal GWG, excessive GWG independently increased the risk of labour induction (RR 1.43, 95% CI 1.02–2.00; p=0.036), cesarean delivery (RR 1.64, 95% CI 1.19–2.26; p=0.003), low birth weight (RR 1.70, 95% CI 1.21–2.39; p=0.002), and NICU admission (RR 1.89, 95% CI 1.46–2.45; p<0.001). Shoulder dystocia occurred exclusively among obese women with excessive GWG.
Conclusions: Maternal overweight, obesity, and inappropriate gestational weight gain were significantly associated with adverse maternal and neonatal outcomes. Early identification of women at risk, preconception weight optimization, nutritional counseling, and close antenatal surveillance may help reduce pregnancy-related complications and improve neonatal outcomes.
Key words: Maternal Body Mass Index, Gestational Weight Gain, Pregnancy Outcomes, Maternal Complications, Neonatal Outcomes.