OJOG  Vol.5 No.10 , September 2015
Can Waist Circumference Be Used as an Anthropometric Parameter to Assess the Obesity Related Pregnancy Outcome: A Case Control Study
Abstract: Introduction: The prevalence of obesity is increasing in women of reproductive age. Maternal obesity is associated with increased morbidity and mortality for both mother and offspring. BMI has been criticized as a limited measure of total obesity. Measurement of waist circumference can be useful in the assessment of abdominal obesity and disease risk. The study is aimed to evaluate the waist circumference as an anthropometric parameter in identifying women at risk of developing obstetric complications. Material and Methods: A prospective study was conducted at a tertiary health care centre on 200 antenatal women of age between 18 to 35 years with singleton pregnancy attending the antenatal clinic before 8 weeks of gestation. Women were divided into two groups. Group I included 100 women with waist circumference < 80 cm and Group II included 100 women with waist circumference ≥ 80 cm. Weight, height and waist circumference were measured and BMI was calculated. All the women were followed throughout their pregnancies as per the routine antenatal follow up. The fetomaternal outcome was recorded and analyzed statistically. Results: The two groups were comparable in age, parity and demographic profile. The maternal and neonatal complications—preeclampsia (p = 0.0052, RR 0.5062, 95% CI 0.2935 - 0.8728), gestational diabetes mellitus, preterm labor, postdatism, need for induction of labor (p value 0.0081, RR 0.6263, 95% CI 0.4314, 0.9091), instrumental vaginal delivery, cesarean delivery (p = 0.0072, RR 0.5745, 95% CI 0.3696, 0.8929), shoulder dystocia, PPH, macrosomia, neonatal asphyxia, admission to NICU were reported more in Group II women as compared to Group I. Conclusion: Assessment of waist circumference in early pregnancy provides a simple and practical parameter for predicting obesity related pregnancy outcome. All pregnancies in centrally obese women (waist circumference ≥ 80 cm) shall be acknowledged as high risk.
Cite this paper: Gupta, A. , Mann, S. and Sethi, S. (2015) Can Waist Circumference Be Used as an Anthropometric Parameter to Assess the Obesity Related Pregnancy Outcome: A Case Control Study. Open Journal of Obstetrics and Gynecology, 5, 528-534. doi: 10.4236/ojog.2015.510076.

[1]   World Health Organization (2012) Obesity and Overweight. Report of a WHO Consultation. Fact sheet No 311, World Health Organisation, Geneva.

[2]   Verma, A. and Shrimali, L. (2012) Maternal Body Mass Index and Pregnancy Outcome. Journal of Clinical and Diagnostic Research, 6, 1531-1533.

[3]   National Institute of Health and Clinical Excellance (2006) Obesity: Guidance on the Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. Clinical Guideline, 43.

[4]   Pouliot, M.C., Despres, J.P., Lemieux, S., Moorjani, S., Bouchard, C., Tremblay, A., et al. (1994) Waist Circumference and Abdominal Sagittal Diameter: Best Simple Anthropometric Indices of Abdominal Visceral Adipose Tissue Accumulation and Related Cardiovascular Risk in Men and Women. American Journal of Cardiology, 73, 460-468.

[5]   Heslehurst, N., Ells, L.J., Simpson, H., Batterham, A., Wilkinson, J. and Summerbell, C.D. (2007) Trends in Maternal Obesity Incidence Rates, Demographic Predictors, and Health Inequalities in 36,821 Women over a 15-Year Period. BJOG, 114, 187-194.

[6]   Sebire, N.J., Jolly, M., Harris, J.P., Wadsworth, J., Joffe, M., Beard, R.W., et al. (2001) Maternal Obesity and Pregnancy Outcome: A Study of 287,213 Pregnancies in London. International Journal of Obesity, 25, 1175-1182.

[7]   Oken, E., Rifas-Shiman, S.L., Field, A.E., Frazier, A.L. and Gillman, M.W. (2008) Maternal Gestational Weight Gain and Offspring Weight in Adolescence. Obstetrics & Gynecology, 112, 999-1006.

[8]   Boney, C.M., Verma, A., Tucker, R. and Vohr, B.R. (2005) Metabolic Syndrome in Childhood: Association with Birth Weight, Maternal Obesity, and Gestational Diabetes Mellitus. Pediatrics, 115, e290-296.

[9]   Vasudevan, C., Renfrew, M. and McGurie, W. (2011) Fetal and Perinatal Consequences of Maternal Obesity. Arch Dis Child Fetal Neonatal Ed., 96, F378-F382.

[10]   Bhattacharya, S., Campbell, D.M., Liston, W.A. and Bhattacharya, S. (2007) Effect of Body Mass Index on Pregnancy Outcomes in Nulliparous Women Delivering Singleton Babies. BMC Public Health, 7, 168.

[11]   National Institute of Health and Clinical Excellence (2006) Obesity: Guidance on the Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. NICE Clinical Guidelines No. 43.

[12]   Satter, N., Clark, P., Holmes, A., Lean, M.E.J., Walker, I. and Greer, I. (2001) Antenatal Waist Circumference and Hypertension Risk. Obstetrics & Gynecology, 97, 268-271.

[13]   Wendland, E.M.D.R., Duncan, B.B., Mengue, S.S., Nucci, L.B. and Schmidt, M.I. (2007) Waist Circumference in the Prediction of Obesity-Related Adverse Pregnancy Outcomes. Cadernos de Saúde Pública, 23, 391-398.

[14]   Briese, V., Voigt, M., Wisser, J., Borchardt, U. and Straube, S. (2011) Risks of Pregnancy and Birth in Obese Primiparous Women: An Analysis of German Perinatal Statistics. Archives of Gynecology and Obstetrics, 283, 249-253.

[15]   Brisson, D., Perron, P., Guay, S.P., Gaudet, D. and Bouchard, L. (2010) The “Hypertriglyceridemic Waist” Phenotype and Glucose Intolerance in Pregnancy. Canadian Medical Association Journal, 182, E722-E725.

[16]   Usha Kiran, T.S., Hemmadi, S., Bethel, J. and Evans, J. (2005) Outcome of Pregnancy in a Woman with an Increased Body Mass Index. BJOG: An International Journal of Obstetrics and Gynaecology, 112, 768-772.

[17]   Addo, V.N. (2010) Body Mass Index, Weight Gain during Pregnancy and Obstetric Outcomes. Ghana Medical Journal, 44, 64-69.

[18]   Hendler, I., Goldenberg, R.L., Mercer, B.M., Iams, J.D., Meis, P.J., Moawad, A.H., et al. (2005) The Preterm Prediction Study: Association between Maternal Body Mass Index and Spontaneous and Indicted Preterm Birth. American Journal of Obstetrics & Gynecology, 192, 882-886.

[19]   Cnattingius, S., Villamor, E., Johansson, S., Bonamy, A.E., Persoson, M., Wikstrom, A., et al. (2013) Maternal Obesity and Risk of Preterm Delivery. Journal of the American Medical Association, 309, 2362-2370.

[20]   Burstein, E., Levy, A., Mazor, M., Witznitzer, A. and Sheiner, E. (2008) Pregnancy Outcome among Obese Women: A Prospective Study. American Journal of Perinatology, 25, 561-566.