Maternal BMI in early pregnancy significantly influences gestational weight gain and neonatal outcomes: Study Shows
Obesity has emerged as a global epidemic, often coexisting with metabolic disorders such as diabetes, hypertension, and cardiovascular diseases. Evidence suggests that its origins may begin in utero, as proposed by the Barker hypothesis, which highlights the long-term impact of maternal nutrition on offspring health. Rising obesity trends among Asians have been linked to maternal factors, including early pregnancy body mass index (BMI). This study evaluated the effect of maternal BMI in early pregnancy on gestational weight gain, birth weight, and pregnancy outcomes.
This prospective observational study was conducted at Index Medical College, Indore, among 100 women with singleton pregnancies booked in the first trimester. BMI was recorded at the booking visit, and participants were followed until delivery. Data on gestational weight gain, birth weight, and pregnancy outcomes were collected. Women with pre-existing complications affecting weight or fetal growth were excluded. Statistical analysis was performed using SPSS, applying the Chi-square test.
Higher maternal age was significantly associated with increased BMI (p=0.00). Women with elevated early pregnancy BMI were more likely to exceed recommended weight gain and had a higher risk of adverse outcomes. Overweight women showed increased rates of preterm delivery (56%) and low birth weight (53.6% at term), compared to normal BMI women (40% and 2.1%, respectively; p=0.00). Mean birth weight was lower in the overweight group (2.71 kg vs. 3.05 kg). Fetal growth restriction and oligohydramnios were more frequent in this group.
Obesity has shown an increasing trend since past decades and it continues to increase as shown by a further 6.37% increase in women as highlighted by the National Family Health Survey (NHFS-5, 2019-2021) in India. Study included 100 women attending the Obstetrics and Gynaecology OPD for routine antenatal care at Index Medical College and Research Centre, Indore. Healthy women generally undergo their detailed evaluation only when they find themselves pregnant in our country, and hence pre pregnancy BMI though a reliable marker for weight is not easy to obtain. Also, there is very little weight gain in the early first trimester of pregnancy, hence authors included booking BMI as a marker of maternal weight in our study. of the 100 women were of higher than considered normal in the study, aligning with the general trend of increased weight among women.
This study adds to the growing evidence that maternal obesity leads to adverse pregnancy outcomes. India among other Asian countries has noticed the trend of obesity and its allied health problems in past decades. Women are more affected by this, as per the recent national health survey. Ensuring that women gain weight in accordance to their booking BMI is an intervention which can give rewarding outcomes via so many birth parameters like neonatal birth weight, and avoiding adverse pregnancy outcomes and preterm births.
Authors intend to highlight the intricate relationship between the maternal weight and neonatal birth weight and birth outcomes through our study and hope this helps obstetricians and clinicians everywhere to provide better care to mothers and also in a way, lay foundation of a healthy life ahead for the new born.
Source: Bhadauria / Indian Journal of Obstetrics and Gynecology Research 2026;13(2):263–268
