Burden of Obesity in Nullipara with Singleton Pregnancy and Feto-Maternal Outcomes: A Retrospective Cohort Study From South India

Background: Obesity is surging worldwide among all the age groups. As a result of obesity in reproductive-aged women, an increasing number of pregnancies are being detected with obesity. Optimal health is crucial for healthy mothers, foetuses and neonates. A high body mass index (BMI) poses a unique challenge to obstetricians. This study was conducted to identify the influence of maternal obesity on adverse pregnancy outcomes among nulliparous women with singleton pregnancies. Methodology: A cohort of 642 pregnant women who delivered singleton babies between January 2022 and July 2024 was identified retrospectively. The body mass index was calculated in the first trimester and grouped as underweight, normal, overweight, obese (I), or obese (II) according to the Asia Pacific guidelines. Selected obstetric, perinatal and neonatal adverse outcomes were compared. Results: Compared with pregnancies with a normal BMI, obese pregnancies were significantly more likely to have gestational diabetes mellitus (GDM), hypertension in pregnancy (HIP), caesarean delivery (CD) and macrosomia. Anaemia, low birth weight and growth restriction were less common in the obese group and more common in the underweight group. There was no significant association between threatened abortion, thyroid disorders and preterm deliveries in the study population. The odds of developing GDM were 2.3 (1.63–3.48) and 7.3 (3.79–14.26) for the HIP in the high BMI group. The risk of CD was 1.17 (0.46–2.98), and that of macrosomia was 2.26 (0.92–5.51) in the obese group. Conclusion: Obesity during pregnancy is associated with a significant risk for the feto-maternal dyad. The risk of adverse outcomes increases with increasing obesity. The metabolic changes associated with obesity can be curtailed by physical activity and restriction of weight gain during pregnancy.