Adverse Fetomatenal Outcomes of High BMI in Pregnant Patients Attending a Tertiary Care Hospital

Abstract

Background: Maternal overweight is increasingly recognized as a clinically important risk factor for adverse pregnancy outcomes, yet evidence from tertiary care settings in low- and middle-income countries remains limited. Objective: To compare adverse fetomaternal outcomes between overweight and normal-weight pregnant women attending a tertiary care hospital. Methods: This comparative cohort study was conducted from 8 April 2024 to 8 October 2024 in the Department of Obstetrics and Gynecology, Bolan Medical College/Sandeman Provincial Hospital, Quetta. A total of 100 pregnant women were included, with 50 women in the overweight group and 50 in the normal-weight control group. Women with singleton pregnancies between 8 and 40 weeks of gestation were enrolled. Maternal outcomes included pre-eclampsia, pregnancy-induced hypertension, gestational diabetes mellitus, prolonged labor, cesarean section, wound infection, and postpartum hemorrhage, while fetal outcomes included stillbirth, early neonatal death, shoulder dystocia, and neonatal intensive care unit admission. Comparative analysis was performed using the chi-square test, with p<0.05 considered statistically significant. Results: Overweight women had higher frequencies of pre-eclampsia (26.0% vs 14.0%), pregnancy-induced hypertension (24.0% vs 12.0%), gestational diabetes mellitus (22.0% vs 10.0%), and cesarean section (44.0% vs 16.0%). Fetal and neonatal complications were also more frequent in the overweight group, including stillbirth (20.0% vs 2.0%), early neonatal death (16.0% vs 2.0%), and NICU admission (88.0% vs 10.0%). Conclusion: Maternal overweight was associated with a substantially higher burden of adverse maternal and neonatal outcomes, highlighting the need for early risk identification and closer antenatal surveillance.