Effect of Body Mass Index On Pregnancy Outcome at Kampala International University Western Campus Cohort Study

ABSTRACT Introduction The increasing population of overweight and obese women world-wide is a major public health concern now reaching epidemic proportions. Two thirds of these women are in the reproductive age which has critical consequences for fetal and maternal health. Maternal obesity has been shown to be associated with adverse pregnancy outcomes such as hypertension, diabetes , infections such a urinary tract infections (UTI), preterm labor, increased cesarean delivery; and poor neonatal outcomes such RDS, macrosomia and prematurity . Obesity thus results in increased maternal and perinatal morbidity and mortality with increased costs of provision of healthcare. Objective This study was aimed at determining the effect of high maternal body mass index (BMI) i.e. ≥ 25 and gestational weight gain on pregnancy outcomes. Study setting The study was carried out at the Kampala International University Teaching Hospital labour ward Study design This study was designed as a hospital based cohort study Study population This was comprised of mothers coming to KIU-TH for delivery. A total of 60 women were recruited into the study, the exposed group were women with increased BMI i.e. >25 and the unexposed were women with normal BMI i.e. 18.5-24.9.The exposed were 31 in total and were further divided into overweight group (BMI 25-29.9) with 15 women and obese group (BMI 30-34.9) with 16 women. The unexposed were 29 in number.

Table of Contents

DECLARATION ............................................................................................................................. ....... ii

CERTIFICATE OF SUPERVISION ...................................................................................................... iii

DEPARTMENT CERTIFICATE OF AUTHENTICITY........................................................................ iv

DEDICATION............................................................................................................................. ........... v

ACKNOWLEDGEMENTS.................................................................................................................... vi

TABLE OF CONTENTS .................................................................................................................... ... vi

LIST OF TABLES AND FIGURES ....................................................................................................... ix

LIST OF ABBREVIATIONS................................................................................................................. xi

ABSTRACT............................................................................................................................. ............ xii

INTRODUCTION................................................................................................................. ................. 1

LITERATURE REVIEW ........................................................................................................................ 3

JUSTIFICATION AND UTILITY .......................................................................................................... 9

CONCEPTUAL FRAMEWORK ............................................................ ………………………………………………10.

RESEARCH QUESTION..................................................................................................................... 12

OBJECTIVES............................................................................................................................. .......... 12

STUDY METHODOLOGY .................................................................................................................. 12

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Study Design............................................................................................................................. ............ 12

Study Population ............................................................................................................................. ...... 13

Study area ............................................................................................................................................. 13

Sampling Frame ............................................................................................................................. ....... 14

Exposure of Interest.............................................................................................................................. 14

Sample size estimation .......................................................................................................................... 14

Inclusion Criteria............................................................................................................................. ...... 15

Exclusion Criteria................................................................................................................................. 16

Variables measured ............................................................................................................................. .. 16

MATERIALS AND METHODS........................................................................................................... 17

Procedures and observations.................................................................................................................. 17

Data collection ............................................................................................................................. ......... 18

Quality control of data........................................................................................................................... 19

Data storage .................................................................................................................. ........................ 20

Data Handling and analysis: .................................................................................................................. 20

Data Analysis............................................................................................................................. ........... 21

Data dissemination ................................................................................................................................ 21

ETHICAL CONSIDERATIONS ........................................................................................................... 21

Study approval ............................................................................................................................. ......... 21

Informed consent................................................................................................................................... 21

Confidentiality ............................................................................................................................. ......... 22

Discrimination...................................................................................................................................... 22

Benefits of the Study to Participants...................................................................................................... 22

STUDY LIMITATIONS ....................................................................................................................... 22

RESULTS............................................................................................................................. ................ 23

Sociodermographic characteristics......................................................................................................... 23

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Antenatal Booking Characteristics......................................................................................................... 24

Gestational Weight Gain....................................................................................................................... 25

Obstetric outcomes............................................................................................................................. ... 26

Effect of gestational weight gain on pregnancy outcomes ...................................................................... 32

DISCUSSION............................................................................................................................. .......... 34

Conclusion ............................................................................................................................. ............... 41

Recommendations................................................................................................................................. 41

REFERENCES CITED ......................................................................................................................... 44

APPENDIX 1: CONSENT FORM ........................................................................................................ 49

APPENDIX 2: DATA SHEET FOR EFFECT OF MATERNAL BMI ON PREGNANCY OUTCOMES

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