Effect of Pre-Pregnancy BMI & Gestational Weight Gain on Fetomaternal Outcome

Abstract

This prospective observational cohort study assessed the effect of pre-pregnancy body mass index (BMI) and
gestational weight gain (GWG) on feto-maternal outcomes among 300 antenatal women followed from the first
trimester until delivery and one week postpartum. Nearly half of participants had normal BMI, while 18% were
underweight and 34% were overweight or obese. Adequate GWG was observed in 52%, whereas 24% each had
inadequate and excessive GWG. Increasing BMI was significantly associated with gestational hypertension, pre-
eclampsia, gestational diabetes mellitus, caesarean delivery and postpartum complications. Inadequate GWG was
associated with low birth weight, preterm birth and NICU admission, while excessive GWG was associated with
hypertensive disorders, gestational diabetes, operative delivery and macrosomia. Multivariate analysis identified
overweight, obesity, inadequate GWG and excessive GWG as independent predictors of composite adverse feto-
maternal outcomes. Preconception BMI optimisation, trimester-wise weight monitoring and individualised
antenatal nutritional counselling are essential to improve maternal and neonatal outcomes.