The amplifying effect of maternal obesity on perinatal outcomes in gestational diabetes mellitus

Abstract

Aims: This study aimed to evaluate the impact of maternal body-mass index (BMI) in the first trimester on perinatal outcomes in pregnant women diagnosed with gestational diabetes mellitus (GDM). Methods: This retrospective cohort study included 210 women with GDM, categorized into three groups based on firsttrimester BMI: normal weight (BMI<25.0 kg/m²), overweight (BMI 25.0–29.9 kg/m²), and obese (BMI≥30.0 kg/m²). Perinatal outcomes such as preterm birth, low birth weight, macrosomia, NICU admission, and Apgar scores were compared across groups. Multivariate logistic regression analyses were conducted to evaluate the independent association between obesity and adverse perinatal outcomes. Results: The rates of preterm birth <37 weeks (35.7%, p<0.001) and <34 weeks (11.4%, p=0.016) were significantly higher in the obese group. Although low birth weight (<2500 g) was observed in 10.0% of obese women, this difference was not statistically significant (p=0.211). Macrosomia (≥4000 g) was more frequent in the obese group (11.4%) but did not reach statistical significance (p=0.261). NICU admission rates were higher in obese women (22.9%, p=0.089). In adjusted analyses, obesity was independently associated with increased odds of preterm birth <34 weeks (adjusted OR: 6.01, p=0.012) and low birth weight (adjusted OR: 4.68, p=0.026). Additionally, Spearman correlation analysis revealed a weak, non-significant positive correlation between gestational weight gain and gestational age at birth (r=0.122, p=0.077). Conclusion: In pregnant women with GDM, first-trimester maternal obesity is associated with an increased risk of early preterm birth and low birth weight. These findings underscore the importance of assessing and managing maternal BMI early in pregnancy to improve perinatal outcomes.

Keywords

• Gestational diabetes mellitus
• maternal obesity
• perinatal outcomes
• preterm birth

References

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