Article Text
PDF
Abstract
Background Given the small number of studies on the topic, we aimed to identify the impact of prepregnancy maternal body mass index (BMI) on adverse pregnancy outcomes (POs) in a low-risk, multiethnic population, and to calculate related population attributable fractions (PAFs).
Methods This retrospective cohort study included 1134 nulliparous women of 50 nationalities (classified into Arab and non-Arab ethnicity) in Qatar who had their first antenatal visit at a Primary Healthcare Corporation (PHCC) facility in June 2016–March 2017 and their PO at a Hamad Medical Corporation facility before 10 November 2017. We used multiple imputation to handle missing values and multivariate logistic regression to calculate adjusted ORs (aORs) for adverse POs in overweight and women with obesity.
Results Overweight Arab women and women with obesity were at high risk for gestational diabetes mellitus (GDM) (aOR=2.38, 95% CI 1.51 to 3.84) and caesarean section (aOR=1.57, 95% CI 1.00 to 2.48). Non-Arab women with obesity were at high risk for pre-eclampsia (aOR=3.83, 95% CI 1.00 to 15.00). PAFs showed that 41.63% of pre-eclampsia, 17.36% of pregnancy-induced hypertension, 17.17% of large for gestational age, 15.89% of preterm deliveries, 14.75% of GDM and 13.99% of caesarean sections could be avoided if all mothers had normal prepregnancy BMI. There were no major differences in PAFs by ethnicity.
Conclusion Adverse POs were attributable to maternal obesity. This suggests that, in contrast to existing PHCC protocol, overweight and women with obesity in Qatar should be targeted earlier in their pregnancy; preferably prior to getting pregnant. We observed ethnic differences in the risk of adverse POs.
- maternal BMI
- pregnancy outcomes
- nulliparous
- maternal health
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Statistics from Altmetric.com
Footnotes
Contributors Conceptualisation: SS and UN; methodology: SS and UN; software: SS; validation: SS and UN; formal analysis: SS; investigation: SS and UN; resources: SS; data curation: SS; writing—original draft preparation: SS; writing—review and editing: SS and UN; visualisation: SS and UN; supervision: UN; project administration: SS; funding acquisition: UN.
Funding This work has been funded by Qatar University (grant no: QUST-1-CHS-2018-14) and Qatar National Library.
Disclaimer All authors have seen and approved the final version of the manuscript being submitted. They warrant that the article is the authors' original work, has not received prior publication and is not under consideration for publication elsewhere.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethical approval was obtained from The Primary Health Care Corporation (Reference Number PHCC/RS/17/07/007) on 3 October 2017 and the Institutional Review Board of Qatar University (Reference QU-IRB 846-E/17) on 11 November 2017.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement The database analysed for this research include information on all antenatal visits to Primary Health Care Centres, between 1 June 2016 and 1 March 2017. Data can be obtained by request from the Primary Health Corporation in Qatar.