An Investigation into Utilising Gestational Body Mass Index As a Screening Tool for Adverse Birth Outcomes and Maternal Morbidities in a Group of Pregnant Women in Khayelitsha

Overview

Journal South Afr J Clin Nutr

Date 2014 Oct 18

PMID 25324710

Citations 4

Authors

Hr Davies

J Visser

M Tomlinson

Mj Rotheram-Borus

C Gissane

J Harwood

I LeRoux

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to investigate the ability of the gestational body mass index (BMI) method to screen for adverse birth outcomes and maternal morbidities.

Design: This was a substudy of a randomised controlled trial, the Philani Mentor Mothers' study.

Setting And Subjects: The Philani Mentor Mothers' study took place in a peri-urban settlement, Khayelitsha, between 2009 and 2010. Pregnant women living in the area in 2009-2010 were recruited for the study.

Outcome Measures: Maternal anthropometry (height and weight) and gestational weeks were obtained at baseline to calculate the gestational BMI, which is maternal BMI adjusted for gestational age. Participants were classified into four gestational BMI categories: underweight, normal, overweight and obese. Birth outcomes and maternal morbidities were obtained from clinic cards after the births.

Results: Pregnant women were recruited into the study (n = 1 058). Significant differences were found between the different gestational BMI categories and the following birth outcomes: maternal (p-value = 0.019), infant hospital stay (p-value = 0.03), infants staying for over 24 hours in hospital (p-value = 0.001), delivery mode (p-value = 0.001), birthweight (p-value = 0.006), birth length (p-value = 0.007), birth head circumference (p-value = 0.007) and pregnancy-induced hypertension (p-value = 0.001).

Conclusion: To the best of our knowledge, this is the first study that has used the gestational BMI method in a peri-urban South African pregnant population. Based on the findings that this method is able to identify unfavourable birth outcomes, it is recommended that it is implemented as a pilot study in selected rural, peri-urban and urban primary health clinics, and that its ease and effectiveness as a screening tool is evaluated. Appropriate medical and nutritional advice can then be given to pregnant women to improve both their own and their infants' birth-related outcomes and maternal morbidities.

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References

Solomons N . Programme and policy issues related to promoting positive early nutritional influences to prevent obesity, diabetes and cardiovascular disease in later life: a developing countries view. Matern Child Nutr. 2006; 1(3):204-15. PMC: 6860957. DOI: 10.1111/j.1740-8709.2005.00030.x. View

. Appropriate technology for birth. Lancet. 1985; 2(8452):436-7. View

Thame M, Wilks R, McFarlane-Anderson N, Bennett F, Forrester T . Relationship between maternal nutritional status and infant's weight and body proportions at birth. Eur J Clin Nutr. 1997; 51(3):134-8. DOI: 10.1038/sj.ejcn.1600357. View

Chopra M, Daviaud E, Pattinson R, Fonn S, Lawn J . Saving the lives of South Africa's mothers, babies, and children: can the health system deliver?. Lancet. 2009; 374(9692):835-46. DOI: 10.1016/S0140-6736(09)61123-5. View

Catalano P, Kirwan J, Haugel-De Mouzon S, King J . Gestational diabetes and insulin resistance: role in short- and long-term implications for mother and fetus. J Nutr. 2003; 133(5 Suppl 2):1674S-1683S. DOI: 10.1093/jn/133.5.1674S. View

Kerenyi Z, Tamas G, Kivimaki M, Peterfalvi A, Madarasz E, Bosnyak Z . Maternal glycemia and risk of large-for-gestational-age babies in a population-based screening. Diabetes Care. 2009; 32(12):2200-5. PMC: 2782977. DOI: 10.2337/dc09-1088. View

Rouse D, Owen J . Prophylactic cesarean delivery for fetal macrosomia diagnosed by means of ultrasonography--A Faustian bargain?. Am J Obstet Gynecol. 1999; 181(2):332-8. DOI: 10.1016/s0002-9378(99)70557-0. View

Moodley J . Maternal deaths due to hypertensive disorders in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2008; 22(3):559-67. DOI: 10.1016/j.bpobgyn.2007.11.004. View

Panaretto K, Lee H, Mitchell M, Larkins S, Manessis V, Buettner P . Risk factors for preterm, low birth weight and small for gestational age birth in urban Aboriginal and Torres Strait Islander women in Townsville. Aust N Z J Public Health. 2006; 30(2):163-70. DOI: 10.1111/j.1467-842x.2006.tb00111.x. View

10.

Metzger B, Coustan D . Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. The Organizing Committee. Diabetes Care. 1998; 21 Suppl 2:B161-7. View

11.

Rotheram-Borus M, le Roux I, Tomlinson M, Mbewu N, Comulada W, le Roux K . Philani Plus (+): a Mentor Mother community health worker home visiting program to improve maternal and infants' outcomes. Prev Sci. 2011; 12(4):372-88. PMC: 3907085. DOI: 10.1007/s11121-011-0238-1. View

12.

Buchmann E, Tlale K . A simple clinical formula for predicting fetal weight in labour at term--derivation and validation. S Afr Med J. 2009; 99(6):457-60. View

13.

Mei Z, Grummer-Strawn L . Standard deviation of anthropometric Z-scores as a data quality assessment tool using the 2006 WHO growth standards: a cross country analysis. Bull World Health Organ. 2007; 85(6):441-8. PMC: 2636355. DOI: 10.2471/blt.06.034421. View

14.

Nestel P, Rutstein S . Defining nutritional status of women in developing countries. Public Health Nutr. 2002; 5(1):17-27. DOI: 10.1079/PHN2001251. View

15.

Olukoga A . Unit costs of inpatient days in district hospitals in South Africa. Singapore Med J. 2007; 48(2):143-7. View

16.

Zamorski M, Biggs W . Management of suspected fetal macrosomia. Am Fam Physician. 2001; 63(2):302-6. View

17.

Ota E, Haruna M, Suzuki M, Anh D, Tho L, Tam N . Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam. Bull World Health Organ. 2011; 89(2):127-36. PMC: 3040376. DOI: 10.2471/BLT.10.077982. View

18.

Mamabolo R, Alberts M, Levitt N, Delemarre-van de Waal H, Steyn N . Prevalence of gestational diabetes mellitus and the effect of weight on measures of insulin secretion and insulin resistance in third-trimester pregnant rural women residing in the Central Region of Limpopo Province, South Africa. Diabet Med. 2007; 24(3):233-9. DOI: 10.1111/j.1464-5491.2006.02073.x. View

19.

Stanton C, Dubourg D, De Brouwere V, Pujades M, Ronsmans C . Reliability of data on caesarean sections in developing countries. Bull World Health Organ. 2005; 83(6):449-55. PMC: 2626266. DOI: /S0042-96862005000600013. View

20.

Bolzan A, Guimarey L . [Relationships between body mass index during pregnancy in adolescent and adult women, anthropometric indicators of fetal growth and intrauterine growth retardation. La Costa, Argentina, 1999]. Arch Latinoam Nutr. 2001; 51(2):145-50. View