Body mass index and obstetric outcomes in Saudi Arabia: a prospective cohort study

ABSTRACT

We examined the effect of body mass index in early pregnancy on pregnancy outcome since no study in Saudi Arabia has addressed this question. This prospective cohort study involved women registered for antenatal care during the first month of pregnancy at primary health care centers in Al Hassa, Saudi Arabia. Data was collected from records and by direct interview. The study included 787 women. Compared to normal weight women [n=307], overweight [n=187] and obese [n=226] women were at increased risk for pregnancy-induced hypertension [RR=4.9 [95% CI 1.6-11.1] and 6.1 [95% CI 2.1-17.8], respectively], gestational diabetes [RR=4.4 [95% CI 1.2-16.3] and 8.6 [95% CI 2.6-28.8]], preeclamptic toxemia [RR=3.8 [95% CI 1.1-14.6] and 5.9 [95% CI 1.7-20.4]], urinary tract infections [RR=1.4 [95% CI 0.5-3.9] and 3.7 [95% CI 1.7-6.2]], and cesarean delivery [RR=2.0 [95% CI 1.3-3.0] in obese women]. Neonates born to obese women had an increased risk for postdate pregnancy [RR=3.7 [95% CI 1.2-11.6]], macrosomia [RR=6.8 [95% CI 1.5-30.7]], low 1-minute Apgar score [RR=1.9 [95% CI 1.1-3.6]], and admission to neonatal care units [RR=2.1 [95% CI 1.2-2.7]]. On the other hand, low birth weight was less frequent among obese women [RR=0.5 [95% CI 0.3-0.9]] while the risk was high among underweight women [RR=2.3 [95% CI 1.4-3.8]]. Even with adequate prenatal care, overweight and obesity can adversely affect pregnancy outcomes: