Body mass index on outcomes of nulliparous singleton pregnancies in Brunei Darussalam

Article


Htwe, Ohn, Coates, Patrick Desmond, Wint, Zaw, Win, Sandar, Bidin, Herni and Chong, Vue Heng. 2013. "Body mass index on outcomes of nulliparous singleton pregnancies in Brunei Darussalam." Brunei International Medical Journal. 9 (5), pp. 307-314.
Article Title

Body mass index on outcomes of nulliparous singleton pregnancies in Brunei Darussalam

Article CategoryArticle
AuthorsHtwe, Ohn (Author), Coates, Patrick Desmond (Author), Wint, Zaw (Author), Win, Sandar (Author), Bidin, Herni (Author) and Chong, Vue Heng (Author)
Journal TitleBrunei International Medical Journal
Journal Citation9 (5), pp. 307-314
Number of Pages8
Year2013
Place of PublicationBandar Seri Begawan, Brunei Darussalam
Web Address (URL)http://www.bimjonline.com/Past%20Issues/pastissues.htm
Abstract

Introduction: Studies have shown that both overweight and underweight women are more likely to have adverse pregnancy outcomes compared to those with normal body weight. This study assessed the impact of body mass index (BMI) on pregnancy outcomes among primigravid women who delivered at a tertiary hospital.
Materials and Methods: All nulliparous women delivering singleton babies at RIPAS Hospital (1st October 2009 to 30th September 2010, N=1,290) were included. BMI was classified based on the World Health Organisation classification. For analyses, the BMI groups were categorised into three groups; Low (<20.0 kg/m2), Normal (20.1 to 24.9) and High (>25.0). The relative risk (RR) for Gestational Hypertension (GHT), Gestational Diabetes Mellitus (GDM), assisted delivery and induction of labour (IOL) were calculated for the different BMI groups. Results: Overall, 40.4%, 19.8% and 39.8% were categorised as Normal, Low and High BMI respectively. Hypertension (5.8%) and diabetes mellitus (2%) were more common in the High BMI group, while anaemia was common in the Low (34%) and Normal groups (23.8%). The High group were more likely to have GHT and GDM, IOL and likely to need assisted delivery (all p<0.001). Low BMI group had a lower prevalence of GHT and GDM, higher preterm labour, small for gestational age (SGA) babies, and more normal vaginal delivery (all p<0.05). There were no significant differences in admission to special care baby unit and rates of stillbirth or early neonatal death between the different groups. Multivariate analyses (controlled for maternal age and smoking) showed higher risk for GHT (RR=2.6, 95% CI=1.2-5.4) in the Normal and High BMI groups (RR=3.7, 95% CI=1.8-7.5), and GDM among the high BMI group (RR=2.6, 95% CI=1.1-6.1). The risk for assisted delivery was also higher (RR 2.0, 95% CI=1.4-2.9) compared to the Normal and High BMI group (RR 1.3, 95% CI=0.9-1.6) and IOL was higher among normal BMI (RR 1.5, 95% CI=1.0-2.2) and High BMI (2.7, 95% CI = 1.9-4.0) groups.
Conclusions: Maternal BMI was strongly associated with pregnancy complications and outcomes. There is a need for an effective programme to increase awareness of the importance of achieving normal BMI for a healthy pregnancy.

Keywordsdiabetes; perinatal complications; pregnancy outcomes; weight disorders
ANZSRC Field of Research 2020420603. Health promotion
321004. Nutritional science
321502. Obstetrics and gynaecology
Public Notes

Open Access Journal. Published version deposited in accordance with the copyright policy of the publisher. All accepted papers become the permanent property of the BIMJ and may not be published elsewhere without written permission from the BIMJ.

Byline AffiliationsRIPAS Hospital, Brunei
Department of Psychology
University of Brunei Darussalam, Brunei
Institution of OriginUniversity of Southern Queensland
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