Maternal Anthropometric measurements, Pre-pregnancy Body Mass Index, and Fetal Growth Parameters - A Rural Experience

Surekha Tayade, Ritu Singh, Jaya Kore, Neha Gangane
2018 Obstetrics and Gynecology Research  
Low pre-pregnancy BMI is considered a marker for minimal nutrient reserves, fetal growth restriction and adverse pregnancy outcome. This study was conducted to evaluate the influence of pre pregnancy BMI on fetal growth parameters. Methods: A hospital based, cross-sectional, observational study was conducted among pregnant women seeking antenatal care at Kasturba Hospital, Sewagram, a rural institute in central India. Maternal pre-pregnancy BMI was calculated and correlated with new born birth
more » ... ith new born birth weight, birth length, chest circumference, head circumference, arm circumference and ponderal index. Results : Among 500 pregnant women of first trimester, the maternal mean Pre-pregnancy weight, height and Prepregnancy BMI were 47 ± 5.77 kg, 154.43 ± 5.39 cm and 19.78 ± 2.56 kg/m 2 respectively. The mean Pre-pregnancy BMI in the LBW group was 19.25 ± 1.68 kg as compared to 19.98 ± 2.60kg in normal birth weight group with a statistically significant difference (z=3.75, P=0.001, z =25.15, P=0.000). Positive correlation was found between pre pregnancy maternal weight, and BMI with neonatal weight, neonatal length, chest circumference, head circumference and arm circumference. The association was negative with neonatal ponderal index. Mean neonatal length, ponderal index, chest circumference, head circumference a mid-arm circumference were statistically significantly associated with pre-pregnancy BMI. (F=3.797 P=0.010; F=10.623 P=0.0001; F=18.924 P=0.001; F=3.948 P=0.0001; F=3.478, P=0.016 respectively). Conclusions: Women in the geographic region of the study had low body mass index depicting chronic malnourishment. BMI below 19.5 kg/m 2 and above 25 kg/m 2 were good predictors of low birth weight babies and had significant association with birth weight, length, head circumference, arm circumference and chest circumference. Graph 4: Sensitivity and Specificity for low birth weight by Pre-pregnancy BMI. Disscussion Human fetal growth is characterized by sequential patterns of tissue and organ growth, differentiation and maturation. In early gestation, the major determinant of fetal growth is the fetal genome. But in late pregnancy, environmental, nutritional, and hormonal influences become increasingly important [10] . Several maternal anthropometric and demographic variables like pre-gravid weight, height, body mass index, gestational weight gain, parity and gestational age at delivery independently predict birth weight [11] . The present study examined prepregnancy BMI, maternal anthropometry and neonatal parameters. The mean maternal pre pregnancy BMI in the study population was 19.74 ± 2.36. which was much lower than that found by Jeminusi et al. [12] (27.9 ± 4.3 kg/m 2 ) and Koepp et al. [13] (24 ± 4.3 kg/m 2 ) but nearer to an Indian study conducted by Kader et al. [14] (21.3 ± 4.5 kg/m 2 ). The mean pre-pregnancy Body Mass index was found to be 19.25 ± 1.68 kg/m 2 in LBW group and 19.98 ± 2.60 kg/m 2 in normal birth weight group (difference is statistically significant z=3.75, p=0.001). Of total 500 women, 113 (22.6%) are underweight (BMI <18.5 kg/m 2 ) , 371 (74.2%) had BMI between 18.5-24.9 kg/m 2 , 8 (1.6%) between 25-29.9 kg/m 2 and 8 (1.6%) were obese with BMI > 30 kg/m 2 . This distribution is much different from developed countries wherein less pregnant women have lean weight and more are obese. In the United States of America, for example, 2% of pregnant women have a BMI <18.5 and more than 50% have a BMI > 25 (15). In a study done in Canada by Vinturache et al. [15] of the 1996 participants included in the study, 1313 (65.8%) were normal weight, 427 (23.6%) were overweight and 211 (10.6%) were obese from which 31 had BMI ≥ 40 kg/m 2 . Yekta et al. [16] (2004) in his study on 270 women reported that only half of subjects had normal BMI (19.8-26). However , in a study done by Masho et al. [17] over two-thirds of the study population had normal prepregnancy weight (68.9%); and 15% and 6% were overweight and obese, respectively. In the present study too, more women had normal or low BMI (96.8%) and very few (3.2%) were overweight and obese. The population in 0.00%
doi:10.26502/ogr.4560009 fatcat:ywdt2i3prvcxnnfunhdq4dx3pa