Prevalence of obesity among Bangladeshi pregnant women at their first trimester of pregnancy

Main Article Content

Shatabdi Goon

Abstract

BACKGROUND: Paradoxically, the escalating global epidemic of maternal obesity coexists with malnutrion in many areas of Bangladesh. This proves a major challenge to obstetric practice from preconception to postpartum due to related comorbid conditions including: maternal death or severe morbidity, gestational diabetes and hypertension, increased risk of early and recurrent miscarriage, pre-eclampsia, thromboembolism, post-caesarean wound infection, postpartum haemorrhage, and low breastfeeding rates. A dramatic increase in birth defects and other pregnancy-induced disorders related to maternal obesity has added millions of dollars to health care costs leading great economical loss to the country.

OBJECTIVE: The study was designed to determine the prevalence of obesity among Bangladeshi pregnant women in their 1st trimester of pregnancy.

STUDY DESIGN: 426 pregnant women presenting to the antenatal care until of Azimpur maternity hospital of Dhaka, Bangladesh were randomly selected for this cross sectional study to determine their weight status using body mass index (BMI, kg/m2).

RESULT: 90 (21.2%) pregnant women were reported as obese with pregnancy BMI of >30 kg/m2. 171 (40.1%) and140 (32.8%) pregnant women were reported as overweight and healthy with pregnancy BMI of 25-29.9 kg/m2 and 18.5-24.9 kg/m2, respectively.Statistical analysis revealed obesity and overweight status were found to be significantly associated with age; women aged 31 or above were more likely to be obese (OR=2.5; 95% CI 1.53–3.96) and overweight (OR=3.3; 95% CI 2.15–4.99).

CONCLUSION: This study provides evidence of increasing trends in obesity among Bangladeshi pregnant women, which poses possible health risks both for mother and child. The findings of this study may act as baseline data for monitoring the effectiveness of national programs for the prevention and control of maternal obesity.

Article Details

How to Cite
Goon, S. (2013). Prevalence of obesity among Bangladeshi pregnant women at their first trimester of pregnancy. Central Asian Journal of Global Health, 2(2). https://doi.org/10.5195/cajgh.2013.70
Section
Research
Author Biography

Shatabdi Goon, Nutrition and Food Engineering Department, Daffodil International University

Research Assistant

References

Heslehurst N, Ells L, Simpson H, Batterham A, Wilkinson J, Summerbell C. Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36,821 women over a 15-year period. BJOG. 2007;114(2):187-194.

Guelinckx I, Devlieger R, Beckers K, Vansant G. Maternal obesity: Pregnancy complications, gestational weight gain and nutrition. Obes Rev. 2008;9(2):140-150.

Callaway L, Prins J, Chang A, McIntyre H. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust. 2006;184(2):56-59.

Hillemeier M, Weisman C, Chuang C, Downs D, McCall-Hosenfeld J, Camacho F. Transition to overweight or obesity among women of reproductive age. J Womens Health (Larchmt). 2011;20(5):703-710.

Flegal K, Carroll M, Kit B, Ogden C. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. 2012;307(491-497).

Centers for Disease Control and Prevention. State-specific prevalence of obesity among adults — United States, 20092010.

Balarajan Y, Villamor E. Nationally representative surveys show recent increases in the prevalence of overweight and obesity among women of reproductive age in Bangladesh, Nepal, and India. J Nutr. 2009;139(11):2139-2144.

Chu S, Kim S, Bish C. Prepregnancy obesity prevalence in the United States, 2004-2005. Matern Child Health J. 2009;13(5):614-620.

Institute of Medicine. Nutrition during pregnancy. Part I, weight gain. Washington, DC, 1990.

Sebire N, Jolly M, Harris J, et al. Maternal obesity and pregnancy outcome: A study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord. 2001;25(8):1175-1182.

Cedergren M. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstetrics and gynecology. 2004;103(2):219-224.

Aimukhametova G, Ukybasova T, Hamidullina Z, et al. The impact of maternal obesity on mother and neonatal health: A study in a tertiary hospital of Astana, Kazakhstan. Nagoya J Med Sci. 2012;74(1-2):83-92.

Voigt M, Straube S, Zygmunt M, Krafczyk B, Schneider K, Briese V. Obesity and pregnancy--a risk profile. Z Geburtshilfe Neonatol. 2008;212(6):201-205.

Adult Treatment Panel III. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report2002.

Arner P. Differences in lipolysis between human subcutaneous and omental adipose tissues. Ann Med. 1995;27:435-438.

Drake A, Reynolds R. Impact of maternal obesity on offspring obesity and cardiometabolic disease risk. Reproduction. 2010;140(3):387-398.

Watkins M, Rasmussen S, Honein M, Botto L, Moore C. Maternal obesity and risk for birth defects. Pediatrics. 2003;111(5 Pt 2):1152-1158.

Blomberg M, Kallen B. Maternal obesity and morbid obesity: The risk for birth defects in the offspring. Birth Defects Res A Clin Mol Teratol. 2009;88(1):35-40.

Shaw G, Velie E, Schaffer D. Risk of neural tube defect-affected pregnancies among obese women. JAMA. 1996;275(14):1093-1096.

Werler M, Louik C, Shapiro S, Mitchell A. Prepregnant weight in relation to risk of neural tube defects. JAMA. 1996;275(14):1089-1092.

Rasmussen S, Chu S, Kim S, Schmid C, Lau J. Maternal obesity and risk of neural tube defects: A metaanalysis. Am J Obstet Gynecol. 2008;198(6):611-619.

Watkins M, Scanlon K, Mulinare J, Khoury M. Is maternal obesity a risk factor for anencephaly and spina bifida? Epidemiology. 1996;7(5):507-512.

Fraser A, Tilling K, Macdonald-Wallis C, et al. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation. 2010;121(23):2557-2564.

Reynolds R, Allan K, Raja E, et al. Maternal obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: Follow-up of 1,323,275 person years. BMJ. 2013;347:f4539.

Straughen J, Trudeau S, Misra V. Changes in adipose tissue distribution during pregnancy in overweight and obese compared with normal weight women. Nutr Diabetes. 2013;3:e84.

Roman H, Robillard P, Hulsey T, et al. Obstetrical and neonatal outcomes in obese women. West Indian Med J. 2007;56(5):421-426.

Heslehurst N, Rankin J, Wilkinson J, Summerbell C. A nationally representative study of maternal obesity in England, UK: Trends in incidence and demographic inequalities in 619 323 births, 1989-2007. Int J Obes (Lond). 2010;34(3):420-428.

Hedderson M, Williams M, Holt V, Weiss N, Ferrara A. Body mass index and weight gain prior to pregnancy and risk of gestational diabetes mellitus. Am J Obstet Gynecol. 2008;198(4):409.

Chu S, Callaghan W, Kim S, et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007;30(8):2070-2076.

Alanis M. Maternal super-obesity (body mass index > or = 50) and adverse pregnancy outcomes. Acta Obstet Gynecol Scand. 2010;89(7):924-930.

Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet. 2006;93(3):269-274.

Athukorala C, Rumbold A, Willson K, Crowther C. The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy Childbirth. 2010;10:56.

Mandal D, Manda S, Rakshi A, Dey R, Biswas S, Banerjee A. Maternal obesity and pregnancy outcome: A prospective analysis. J Assoc Physicians India. 2011;59:486-489.

McIntyre H, Gibbons K, Flenady V, Callaway L. Overweight and obesity in Australian mothers: Epidemic or endemic? Med J Aust. 2012;196(3):184-188.

Kerrigan A, Kingdon C. Maternal obesity and pregnancy: A retrospective study. Midwifery. 2010;26(1):139-146.

Nucci L, Schmidt M, Duncan B, Fuchs S, Fleck E, Santos Britto M. Nutritional status of pregnant women: Prevalence and associated pregnancy outcomes. Rev Saude Publica. 2001;35(6):502-507.

Abrams B, Parker J. Overweight and pregnancy complications. Int J Obes. 1988;12(4):293-303.

Kumari A. Pregnancy outcome in women with morbid obesity. Int J Gynaecol Obstet. 2001;73(2):101-107.

O'Brien T, Ray J, Chan W. Maternal body mass index and the risk of preeclampsia: A systematic overview. Epidemiology. 2003;14(3):368-374.

Usha Kiran T, Hemmadi S, Bethel J, Evans J. Outcome of pregnancy in a woman with an increased body mass index. BJOG. 2005;112(6):768-772.

Kristensen J, Vestergaard M, Wisborg K, Kesmodel U, Secher N. Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG. 2005;112(4):403-408.

Nohr E, Bech B, Davies M, Frydenberg M, Henriksen T, Olsen J. Prepregnancy obesity and fetal death: A study within the Danish National Birth Cohort. Obstetrics and gynecology. 2005;106(2):250-259.

Tennant P, Rankin J, Bell R. Maternal body mass index and the risk of fetal and infant death: A cohort study from the North of England. Hum Reprod. 2011;26(6):1501-1511.

Conner S, Verticchio J, Tuuli M, Odibo A, Macones G, Cahill A. Maternal obesity and risk of postcesarean wound complications. Am J Perinatol. 2013.

Sheiner E, Levy A, Menes T, Silverberg D, Katz M, Mazor M. Maternal obesity as an independent risk factor for caesarean delivery. Paediatr Perinat Epidemiol. 2004;18(3):196-201.

Ehrenberg H, Mercer B, Catalano P. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol. 2004;191(3):964-968.

Smith G, Shah I, Pell J, Crossley J, Dobbie R. Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: A retrospective cohort study. Am J Public Health. 2007;97(1):157-162.

Weiss J, Malone F, Emig D, et al. Obesity, obstetric complications and cesarean delivery rate--a population-based screening study. Am J Obstet Gynecol. 2004;190(4):1091-1097.

Metwally M, Ong K, Ledger W, Li T. Does high body mass index increase the risk of miscarriage after spontaneous and assisted conception? A meta-analysis of the evidence. Fertil Steril. 2008;90(3):714-726.

Leung T, Leung T, Sahota D, et al. Trends in maternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinese women. BJOG. 2008;115(12):1529-1537.

Nohr E, Vaeth M, Bech B, Henriksen T, Cnattingius S, Olsen J. Maternal obesity and neonatal mortality according to subtypes of preterm birth. Obstetrics and gynecology. 2007;110(5):1083-1090.

Cnattingius S, Villamor E, Johansson S, et al. Maternal obesity and risk of preterm delivery. JAMA. 2013;309(22):2362-2370.

Kamanu C, Onwere S, Chigbu B, Aluka C, Okoro O, Obasi M. Fetal macrosomia in African women: A study of 249 cases. Arch Gynecol Obstet. 2009;279(6):857-861.

Bowers D, Cohen W. Obesity and related pregnancy complications in an inner-city clinic. J Perinatol. 1999;19(3):216-219.

Poston L, Harthoorn L, Van Der Beek E, Contributors to the ILSI Europe Workshop. Obesity in pregnancy: Implications for the mother and lifelong health of the child. A consensus statement. Pediatr Res. 2011;69(2):175-180.

Arrowsmith S, Wray S, Quenby S. Maternal obesity and labour complications following induction of labour in prolonged pregnancy. BJOG. 2011;118(5):578-588.

Tenenbaum-Gavish K, Hod M. Impact of maternal obesity on fetal health. Fetal Diagn Ther. 2013.

Koch L. Obesity: Effect of maternal obesity on neonatal outcomes. Nat Rev Endocrinol. 2013.

Higgins L, Mills T, Greenwood S, Cowley E, Sibley C, Jones R. Maternal obesity and its effect on placental cell turnover. J Matern Fetal Neonatal Med. 2013;26(8):783-788.

Li R, Jewell S, Grummer-Strawn L. Maternal obesity and breast-feeding practices. Am J Clin Nutr. 2003;77:931-936.

Maasilta P, Bachour A, Teramo K, Polo O, Laitinen L. Sleep-related disordered breathing during pregnancy in obese women. Chest. 2001;120:1448-1454.

SPSS for Windows [computer program]. Version 15.0. Chicago: SPSS Inc.; Released 2006.

Fattah C, Farah N, Barry S, O'Connor N, Stuart B, Turner M. Maternal weight and body composition in the first trimester of pregnancy. Acta Obstet Gynecol Scand. 2010;89(7):952-955.

Akter J, Shahjahan M, Hossain S, Chowdhury H, Ali L. Prevalence and determinants of overweight and obesity among diabetic women of reproductive age attending a tertiary care hospital in Bangladesh.

Yogev Y, Langer O. Pregnancy outcome in obese and morbidly obese gestational diabetic women. Eur J Obstet Gynecol Reprod Biol. 2008;137(1):21-26.

Boseley S. More than one in 20 pregnant women severely obese. The Guardian. December 7, 2010, 2010.

Lashen H, Fear K, Sturdee DW. Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case-control study. Human reproduction (Oxford, England). Jul 2004;19(7):1644-1646.

Poston L. Maternal obesity, gestational weight gain and diet as determinants of offspring long term health. Best Pract Res Clin Endocrinol Metab. 2012;26(5):627-639.