Association between maternal and fetal outcomes in high BMI diabetic and non-diabetic groups

Rezwana Kabir, Sumona Parvin, M. Ubaidul Islam, Ferdousi Begum


Background: BMI has increased among the women of reproductive age worldwide. Insulin resistance associated with obesity and diabetes are mostly responsible for the adverse outcomes like macrosomia, maternal morbidity, increased operative interference and NICU admission. Objectives of the study was to assess maternal high BMI and its association with maternal and neonatal outcomes in diabetic and non-diabetic groups.

Methods: A cross sectional study was conducted in the BIRDEM General Hospital Dhaka on 200 pregnant women with high BMI at 3rd trimester. Patients were allocated in two equal groups- Group I Diabetic and group II Non-diabetic.

Results: Age range was 18 to 35 years with mean age of 26.9±8.3 years among diabetic and 25.7±7.8 years among non-diabetic women. BMI was comparatively higher in diabetic group. Overall frequency of C/S was higher (89.5%) and on comparison between the groups, frequency was significantly higher in diabetic group (94% vs 85% in group I and group II respectively). The postpartum complications were also significantly higher in diabetic group (22% vs 7% in Group I and Group II respectively). About 23 (11.5%) of the babies had birth weight more than 3.5 kg (maximum among diabetic mothers 15% vs 8% in group I and II). The mean birth weight was higher in diabetic group 3.7 ± 0.4 kg vs 2.6±0.5 kg in non-diabetic group respectively. On the neonatal outcomes, significant number of macrosomia were found in the diabetic group, and NICU admissions were also higher in the diabetic group.

Conclusions: High BMI diabetic mothers have significantly higher maternal and neonatal complications.


Caesarean section, Diabetes, Obesity, Macrosomia, NICU

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Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol. 2008;1(4):170-8.

Miao M, Dai M, Zhang Y, Sun F, Guo X, Sun G. Influence of maternal overweight, obesity and gestational weight gain on the perinatal outcomes in women with gestational diabetes mellitus. Sci Rep. 2017;7:305.

Ali A, Mehrass A, Al-adhroey A, Al-shammakh A. Prevalence and risk factors of gestational diabetes mellitus in Yemen. Int J Women’s Health. 2016;8:35-41.

Modi N, Murgasova D, Martin R. The influence of maternal body mass index on infant adiposity and hepatic lipid content. Pediatr Res. 2011;70:287-91.

John J, Mahendran M. Maternal and fetal outcomes of obese pregnant women: a prospective cohort study. Int J Reprod Contracept Obstet Gynecol. 2017;6:725-9.

Metgud CS, Naik VA, Mallapur MD. Factors affecting birth weight of a newborn - a community based study in rural Karnataka, India. PLoS ONE. 2015;7(7): e40040.

Lim J, Lee J, Kim J, Hwang Y, Kim T, Yong S, et al. Comparison of World health Organization and Asia-Pacific body mass index classifications in COPD patients. International J COPD. 2017;12:2465-75.

Sayeed MA, Mahtab H, Khanam PA, Begum R, Banu A, Khan AK. Diabetes and hypertension in pregnancy in a rural community of Bangladesh: a population-based study. Diabet Med. 2005;22(9):1267-71.

Begum S, Huda SN, Musarrat N, Ahmed S, Banu LA, Ali SM. Nutritional status and birth outcomes of the diabetic and non-diabetic pregnant women. Bangladesh Med Res Counc Bull. 2002;28(3):97-103.

Huong NT. Birth weight and growth during the first two years of life: a study in urban and rural Vietnam. Doctoral thesis at the Nordic School of Public Health NHV, Gothenburg, Sweden 2014:1-23.

Goldman M, Kitzmiller JL, Abrams B, Cowan RM, Laros RK. Obstetric complications with gdm: effects of maternal weight. Diabetes. 1991;40(2):79-82.

Rosenberg TJ, Garbers S, Lipkind H, Chiasson MA. Maternal obesity and diabetes as risk factors for adverse pregnancy outcomes: differences among 4 racial/ethnic groups. Am J Public Health (AJPH). 2005;2:87-9.

Negrato CA, Mattar R, Gomes MB. Adverse pregnancy outcomes in women with diabetes. Diabetol Metab Syndrome. 2012;4:41.

Abanihe U, Olubukola A. Maternal and environmental factors influencing infant birth weight in Ibadan, Nigeria. Afr Population Studies. 2011;25(2):250-66.

Gillman MW, Shiman SR, Berkey CS, Field AE, Colditz GA. Maternal gestational diabetes, birth weight, and adolescent. Obesity Pediatrics. 2003;111(3):e221-e6.

Timur BB, Timur H, Tokmak A, Isik H, Eyi EG. Influence of maternal obesity on pregnancy complications and neonatal outcomes in diabetic and non-diabetic women. Geburtshilfe Frauenheilkd. 2018;78(4):400-6.

Barrere D. There are a number of factors, actually. Available at http:// pregnancy and baby. com/ baby/articles/940601/what-affects-a-babys-birth-weight. Accessed on 11 November 2017.

Shengqi L. Maternal body composition late in pregnancy and infant body composition at birth. University of Kansas Ku Scholarworks. 2013.

Lumbanraja S, Lutan D, Usman I. Maternal weight gain and correlation with birth weight infants. Int Edu Technol Con. 2013;103:647-56.