Introduction: About 12.3% of all maternal deaths occur due to hypertensive disease of pregnancy (HDP). Obesity as measured by the body mass index (BMI) is a major risk factor for development and progression of HDP. The objective of the study was to evaluate the association of the various maternal and neonatal complications with the BMI in women with HDP. Materials and methods: Primigravida women were recruited at their first visit and BMI noted. Examination and all relevant investigations were done at all visits. A total of 45 women who developed HDP were included in the study. Any maternal or neonatal complication was recorded. Results: Most maternal complications like abruptio placentae and pulmonary edema were more in those women with higher BMI. Fetal growth restriction and neonatal complications were also observed more in women with BMI >24.9 kg/m2. Conclusion: Maternal and neonatal complications are significantly more in overweight women. Close monitoring of the blood pressure from the earliest of these women should be done. Clinical significance: Primary preventive measures by weight reduction prior to pregnancy and close monitoring of overweight women will help prevent the maternal and neonatal complications and improve outcome.
Census of India. Chapter 3 Report on Medical Certification of Cause of Death.2017. Office of the Registrar General, India Government Of India, Ministry of Home Affairs, Vital Statistics Division, R. K. Puram, New Delhi https://censusindia.gov.in/2011-Documents/mccd_Report1/MCCD_Report-2017.pdf.
Ohno Y, Kawai M, Wakahara Y, Kitagawa T, Kakihara M, Arii Y. Transcranial assessment of maternal cerebral blood flow velocity in patients with preeclampsia. Acta Obstet Gynecol Scand 1997;76(10):928–932. DOI: 10.3109/00016349709034904.
Cnossen J, Leeflang M, De Haan E, Mol B, Van der Post J, Khan K, et al. Systematic review: accuracy of body mass index in predicting pre- eclampsia: bivariate meta- analysis. BJOG 2007;114(12):1477–1485. DOI: 10.1111/j.1471-0528.2007.01483.x.
Endeshaw G, Berhan Y. Perinatal outcome in women with hypertensive disorders of pregnancy: a retrospective cohort study. Int Sch Res Notices 2015;2015:208043. DOI: 10.1155/2015/208043.
Ganesh KS, Unnikrishnan B, Nagaraj K, Jayaram S. Determinants of pre-eclampsia: a case-control study in a district hospital in South India. Indian J Community Med 2010;35(4):502–505. DOI: 10.4103/0970-0218.74360.
Teppa RJ, Ness RB, Crombleholme WR, Roberts JM. Free leptin is increased in normal pregnancy and further increased in preeclampsia. Metabolism 2000;49(8):1043–1048. DOI: 10.1053/meta.2000.7707.
Ngwenya S. Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo central hospital, Bulawayo, Zimbabwe. Int J Womens Health 2017;9:353–357. DOI: 10.2147/IJWH.S131934.
Kongwattanakul K, Saksiriwuttho P, Chaiyarach S, Thepsuthammarat K. Incidence, characteristics, maternal complications, and perinatal outcomes associated with preeclampsia with severe features and HELLP syndrome. Int J Womens Health 2018;10:371–377. DOI: 10.2147/IJWH.S168569.
Bodnar LM, Ness RB, Markovic N, Roberts JM. The risk of preeclampsia rises with increasing prepregnancy body mass index. Ann Epidemiol 2005;15(7):475–482. DOI: 10.1016/j.annepidem.2004.12.008.
Briana DD, Malamitsi-Puchner A. Adipocytokines in normal and complicated Pregnancies. Reprod Sci 2009;16(10):921–937. DOI: 10.1177/1933719109336614.
Wolf M, Kettyle E, Sandler L, Ecker JL, Roberts J, Thadhani R. Obesity and preeclampsia: the potential role of inflammation. Obstet Gynecol 2001;98(5 Pt 1):757–762. DOI: 10.1097/00006250-200111000-00009.
Kupferminc MJ, Peaceman AM, Wigton TR, Rehnberg KA, Socol ML. Tumor necrosis factor-alpha is elevated in plasma and amniotic fluid of patients with severe preeclampsia. Am J Obstet Gynecol 1994;170(6):1752–1757. DOI: 10.1016/S0002-9378(94)70351-5. discussion 1757-1759.
Laivuori H, Kaaja R, Koistinen H, et al. Leptin during and after preeclamptic or normal pregnancy: its relation to serum insulin and insulin sensitivity. Metabolism 2000;49(2):259–263. DOI: 10.1016/s0026-0495(00)91559-2.