Maternal BMI and pregnancy outcomes: An analytical basis for health promotion strategies
Abstract
Background: The nutritional status of pregnant women, as assessed by Body Mass Index (BMI), plays a crucial role in influencing the process and outcomes of childbirth. BMI is used as an indicator of maternal nutritional status, categorized as underweight (<18.5), normal (18.5–24.9), and overweight (≥25). BMI has been shown to be associated with various maternal complications. Although BMI demonstrates a significant impact on maternal outcomes, further research is needed to serve as a basis for health promotion strategies in antenatal care services.
Objective: This study aims to analyze the relationship between maternal BMI and pregnancy outcomes, and to establish an analytical basis for health promotion strategies.
Methods: This study used an observational analytical design with a cross-sectional approach and was conducted in the working area of Ngemplak I Health Center, Sleman, Special Region of Yogyakarta. The research sample was 98 pregnant women who met the inclusion criteria, selected using a purposive sampling technique. Data were collected through questionnaires sourced from the KIA book, then analyzed using the Chi-Square test with a significance level of p <0.05.
Results: The study showed a significant relationship between maternal BMI and type of delivery (p = 0.037), while no significant associations were found with hemorrhage (p = 0.620), premature labor (p = 0.820), and prolonged labor (p = 0.825).
Conclusion: There is a significant relationship between maternal nutritional status based on BMI and the type of delivery. However, no significant relationship was observed with hemorrhage, premature labor, or prolonged labor. These findings can serve as a basis for health promotion strategies, particularly in nutritional education during pregnancy to prevent delivery complications
References
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23. Wang, C., & Zhang, C. (2023). Meta-analysis to assess the role of maternal characteristics and risk factors on postpartum hemorrhage. Advances in clinical and experimental medicine : official organ Wroclaw Medical University , 32 (7), 723–731. https://doi.org/10.17219/acem/158474
24. Yamamura, S., Yamaguchi, K., Hayashi, I., Nagai, N., Sakane, N., Ikeda, A., Takakura, M., Emoto, I., Ujita, M., Kawasaki, K., Abiko, K., Takao, Y., Takakura, K., & Konishi, I. (2020). Postpartum hemorrhage is associated with neonatal body weight, pre-pregnancy body mass index, and maternal weight gain. Clin. Exp. Obstet. Gynecol., 47(6), 920–925. https://doi.org/10.31083/j.ceog.2020.06.5365
25. Whitley, J., Dazelle, W., Kripalani, S., & Ahmadzia, H. (2023). The association between body mass index and postpartum hemorrhage after cesarean delivery. Scientific reports ,13 (1), 11998. https://doi.org/10.1038/s41598-023-38526-7
26. Wulandari, F., Budihastuti, UR, & Pamungkasari, EP (2021). Meta-Analysis of the Effect of Maternal Obesity on the Risk of Premature Birth and Neonatal Death. Journal of Maternal and Child Health , 6(6), 10. https://doi.org/10.26911/thejmch.2021.06.06.10
27. Cornish, R.P., Magnus, M.C., Urhoj, S.K., Santorelli, G., Smithers, L.G., Odd, D., ... & Lawlor, D.A. (2024). Maternal pre-pregnancy body mass index and risk of preterm birth: a collaboration using large routine health datasets. BMC medicine , 22 (1), 10. https://doi.org/10.1101/2023.04.12.23288473
28. Niknam, A., Behboudi †Gandevani, S., Rahmati, M., Firouzi, F., Azizi, F., & Ramezani Tehrani, F. (2024). Gestational weight gain as a mediator of the relationship between pre †pregnancy body mass index and the risk of preterm birth: A four †way decomposition analysis. International Journal of Gynecology & Obstetrics , 167 (3), 1168-1177. https://doi.org/10.1002/ijgo.15789
29. Carlhäll, S., et al. (2020). The effect of maternal body mass index on duration of induced labor. Acta Obstetricia et Gynecologica Scandinavica, 99(10), 1386–1393. https://doi.org/10.1111/aogs.13795
30. Stotland, N.E., et al. (2021). Obesity, labor progress, and cesarean delivery. American Journal of Obstetrics & Gynecology MFM, 3(3), 100353. https://doi.org/10.1016/j.ajogmf.2021.100353
2. WHO. (2022). Obesity and overweight . https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
3. UNICEF. (2021). The State of the World's Children 2021 . https://www.unicef.org/reports/state-of-worlds-children-2021
4. Riskesdas. (2018). National Report of Riskesdas 2018. Health Research and Development Agency, Ministry of Health of the Republic of Indonesia. https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/1/Laporan%20Riskesdas%202018%20Nasional.pdf
5. Khalifa, E., El-Sateh, A., Zeeneldin, M., et al. (2021). Effect of maternal BMI on labor outcomes in primigravida pregnant women . BMC Pregnancy and Childbirth, 21, 753.
DOI: https://doi.org/10.1186/s12884-021-04236-z
6. Aggarwal, S., Behal, M., Singal, N., Minhas, S., & Dagar, S. (2022). Effect Of Maternal Body Mass Index On The Mode Of Delivery And Neonatal Outcome: A Tertiary Care Hospital Based Study In Solan, Himachal Pradesh. International Journal of Medical Science And Diagnostic Research , 6 (2). https://doi.org/10.32553/ijmsdr.v6i2.912
7. Rahmawati, F., Akbar, A., Ilham, M., & Atika, A. (2021). The Effect of BMI of Pregnant Women with Preeclampsia on Perinatal Outcomes. Indonesian Midwifery and Health Sciences Journal , 3 (2), 148-159. https://doi.org/10.20473/imhsj.v3i2.2019.148-159
8. Paisal, FI, Mutaqin, ZZ, Azriani, D., & Kristianto, J. (2023). The Effect of Body Mass Index of Pregnant Women on Neonatal in the DKI Jakarta Region. Journal of Health Science , 4 (1), 30-37. https://doi.org/10.46799/jhs.v4i1.657
9. Andola, KS , Sinhasane, H. Kurle, RS, Andola, US, Andola, SS, (2021). Effect of Maternal Body Mass Index on Intrapartum and Neonatal Outcome in Nulliparous Women in North Karnataka: A Prospective Cohort Study , J Clin of Diagn Res. 15 (8), QC05-QC09. https://www.doi.org/10.7860/JCDR/2021/50002/15278
10. El-Garhy, I. M. T., & Saeed, A. M. (2021). Impact of maternal body mass index on progress and outcome of labor in nulliparous females. Al-Azhar International Medical Journal , 2 (10), 31-36. https://doi.org/10.21608/aimj.2021.91324.1552
11. Atwani, R., Saade, G.R., & Kawakita, T. (2024). Impact of Attempted Mode of Delivery on Neonatal Outcomes in Nulliparous Individuals According to Body Mass Index. American Journal of Perinatology, 42 , 1003 - 1011. DOI: 10.1055/a-2451-9197
12. Huang, Y., Li, X., Wang, Y., et al. (2024). Association between maternal BMI and mode of delivery: A population-based cohort study. International Journal of Gynecology & Obstetrics, 167(1), 45–52. https://pubmed.ncbi.nlm.nih.gov/38894748
13. Berger, H., Melamed, N., Davis, B.M., Hasan, H., Mawjee, K., Barrett, J., ... & Ray, J.G. (2020). Impact of diabetes, obesity and hypertension on preterm birth: Population-based study. PLoS One , 15 (3), e0228743. https://doi.org/10.1371/journal.pone.0228743
14. Salman, MM, Ghanem, RMK, Wasef, ANF, & El Aleem, MMA (2022). Effect of body mass index (BMI) on mode of delivery and maternal and neonatal complications in nulliparous women. GinPol Med Project . DOI: https://doi.org/10.17772/gp/14686
15. Mahboubi, A., Jamil, M., & Hassan, Z. (2023). Maternal obesity and postpartum hemorrhage: A systematic review. BMC Pregnancy and Childbirth, 23(1), 125. https://pmc.ncbi.nlm.nih.gov/articles/PMC10862445
16. Zhang, Y., Lu, M., Yi, Y., Xia, L., Zhang, R., Li, C., & Liu, P. (2024). Influence of maternal body mass index on pregnancy complications and outcomes: a systematic review and meta-analysis. Frontiers in Endocrinology , 15 , 1280692. DOI: 10.3389/fendo.2024.1280692
17. Vats, H., Saxena, R., Sachdeva, M. P., Walia, G. K., & Gupta, V. (2021). Impact of maternal pre-pregnancy body mass index on maternal, fetal and neonatal adverse outcomes in the worldwide population: a systematic review and meta-analysis. Obesity Research & Clinical Practice , 15 (6), 536-545. https://doi.org/10.1016/j.orcp.2021.10.005
18. Sun, Y., Shen, Z., Zhan, Y., Wang, Y., Ma, S., Zhang, S., ... & Jiang, Y. (2020). Effects of pre-pregnancy body mass index and gestational weight gain on maternal and infant complications. BMC pregnancy and childbirth , 20 , 1-13. https://doi.org/10.1186/s12884-020-03071-y
19. Aji, AS, Lipoeto, NI, Yusrawati, Y., Malik, SG, Kusmayanti, NA, Susanto, I., ... & Vimaleswaran, KS (2022). Association between pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes: a cohort study in Indonesian pregnant women. BMC pregnancy and childbirth , 22 (1), 492. https://doi.org/10.1186/s12884-022-04815-8
20. Mekonnen, A., Teale, G., Vasilevski, V., & Sweet, L. (2025). Obesity and cesarean section rates among low †risk primiparous women in Victoria, Australia: A population †based study. Acta Obstetricia et Gynecologica Scandinavica , 104 (4), 729-737. https://doi.org/10.1111/aogs.15054
21. Saadia, Z. (2020). Association between maternal obesity and cesarean delivery complications. Cureus , 12 (3). DOI: 10.7759/cureus.7163
22. Brizan, J. B., & Amabebe, E. (2022). Maternal obesity as a risk factor for caesarean delivery in Sub-Saharan Africa: A systematic review. Life , 12 (6), 906. https://doi.org/10.3390/life12060906
23. Wang, C., & Zhang, C. (2023). Meta-analysis to assess the role of maternal characteristics and risk factors on postpartum hemorrhage. Advances in clinical and experimental medicine : official organ Wroclaw Medical University , 32 (7), 723–731. https://doi.org/10.17219/acem/158474
24. Yamamura, S., Yamaguchi, K., Hayashi, I., Nagai, N., Sakane, N., Ikeda, A., Takakura, M., Emoto, I., Ujita, M., Kawasaki, K., Abiko, K., Takao, Y., Takakura, K., & Konishi, I. (2020). Postpartum hemorrhage is associated with neonatal body weight, pre-pregnancy body mass index, and maternal weight gain. Clin. Exp. Obstet. Gynecol., 47(6), 920–925. https://doi.org/10.31083/j.ceog.2020.06.5365
25. Whitley, J., Dazelle, W., Kripalani, S., & Ahmadzia, H. (2023). The association between body mass index and postpartum hemorrhage after cesarean delivery. Scientific reports ,13 (1), 11998. https://doi.org/10.1038/s41598-023-38526-7
26. Wulandari, F., Budihastuti, UR, & Pamungkasari, EP (2021). Meta-Analysis of the Effect of Maternal Obesity on the Risk of Premature Birth and Neonatal Death. Journal of Maternal and Child Health , 6(6), 10. https://doi.org/10.26911/thejmch.2021.06.06.10
27. Cornish, R.P., Magnus, M.C., Urhoj, S.K., Santorelli, G., Smithers, L.G., Odd, D., ... & Lawlor, D.A. (2024). Maternal pre-pregnancy body mass index and risk of preterm birth: a collaboration using large routine health datasets. BMC medicine , 22 (1), 10. https://doi.org/10.1101/2023.04.12.23288473
28. Niknam, A., Behboudi †Gandevani, S., Rahmati, M., Firouzi, F., Azizi, F., & Ramezani Tehrani, F. (2024). Gestational weight gain as a mediator of the relationship between pre †pregnancy body mass index and the risk of preterm birth: A four †way decomposition analysis. International Journal of Gynecology & Obstetrics , 167 (3), 1168-1177. https://doi.org/10.1002/ijgo.15789
29. Carlhäll, S., et al. (2020). The effect of maternal body mass index on duration of induced labor. Acta Obstetricia et Gynecologica Scandinavica, 99(10), 1386–1393. https://doi.org/10.1111/aogs.13795
30. Stotland, N.E., et al. (2021). Obesity, labor progress, and cesarean delivery. American Journal of Obstetrics & Gynecology MFM, 3(3), 100353. https://doi.org/10.1016/j.ajogmf.2021.100353
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