BMI´s impact on obstetric and perinatal morbility in pregnant women treated at the provincial hospital of Tete, Mozambique

Abstract

Introduction. Fetal growth during pregnancy, is largely determined by maternal nutritional status, valued through Pregestational BMI and Gestational Weight Gain. In Tete, 36.4 % of women giving birth did not have a normal BMI and 72.88 % had inadequate gain, which is responsible for an increased risk of obstetric and perinatal morbidity. Objetives. 1) Determine the nutritional status of the pregnant woman and the relationship of both maternal BMI and weight gain to obstetric and perinatal morbidity at Provincial Hospital of Tete, Mozambique. 2) To compare their relationship with various sociodemographic, infectious, gyneco-obstetric and neonatal variables. Methods. Descriptive observational epidemiological study of cross-sectional design by collecting data at the time of pregnancy and postpartum of all women admitted to Provincial Hospital of Tete between July to September 2018. Results. The study included 129 women. 11.6% were underweight, 63.3% had normal weight and 24.8% were obese. 59.7% presented insufficient gain, 27.12% adequate gain and 13.18% excessive gain. 75.7% came from urban areas, 50.4% had a secondary education and 79.8% were housewives. There was 48.1% adolescent pregnancy, and the risk of excessive gain increased with maternal age (p=0.007). 16.4 % were uncontrolled pregnancies and 57.4 % were nulliparous. Direct morbidity was 22.5%, the most frequent obstetric complication was episiotomy (10.3%), but not significantly. There were 27.6% of cesarean sections, done only in 28.1% of overweight women. Neonatal height was significantly lower in women with insufficient gain (p=0.019) and 17.1% had low neonatal weight, specially in women with insufficient gain, but not significantly. About neonatal complications, there was 13.6% prematurity, 4.7% severe asphyxia and 5.4% mortinatum. Conclusions. The obstetric morbidity had no significant correlation with previous nutritional status and weight gain. On perinatal morbidity, the neonatal height was statistically significant lower in newborns of women with insufficient gain. The majority had a normal weight and controlled pregnancy, despite this, a high percentage had significantly insufficient gain. The majority came from urban areas, had secondary education and were housewives. Women who did not have access to potable water had a higher percentage of insufficient gain. Maternal age was higher in obese mothers and in pregnant women with excessive gain. In addition, overweight women had more percentage of multiparity.