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Published on: June 6, 2020
Maternal Pregestational Body Mass Index and Delivery Outcomes: A Retrospective Study in a Tertiary High-Income
Francesca Parisi1,2, Ottavio Cassardo2,3, Lucrezia Viscioni2
1Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy, unimi.it.
Journal of Nutrition and Metabolism
|June 30, 2026
Summary
Maternal obesity significantly increases risks for preterm birth, cesarean delivery, and neonatal intensive care unit admission. Overweight women also face higher risks, while underweight women have comparable outcomes except for reduced birthweights.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Rising global rates of maternal overweight and obesity pose significant risks to pregnancy and delivery outcomes.
- Pregestational body mass index (BMI) is a critical factor influencing maternal and neonatal health during pregnancy.
- Understanding these risks is crucial for developing targeted interventions and improving obstetric care.
Purpose of the Study:
- To evaluate maternal and neonatal outcomes stratified by pregestational BMI in a tertiary care setting.
- To identify specific risks associated with underweight, normal weight, overweight, and obese pregnancies.
- To inform evidence-based obstetric care and public health strategies.
Main Methods:
- Retrospective analysis of 17,813 singleton pregnancies between 2022-2024 at a Milan tertiary care hospital.
- Classification of women into four BMI groups: underweight (<18.5 kg/m²), normal weight (18.5-24.9 kg/m²), overweight (≥25.0 kg/m²), and obese (≥30.0 kg/m²).
- Comparison of delivery outcomes using adjusted multivariate models (binary logistic regression, generalized linear models).
Main Results:
- Obese women faced significantly higher odds of preterm birth, labor induction, emergency cesarean delivery, postpartum hemorrhage, low 5-minute APGAR scores, and NICU admission compared to normal weight controls.
- Overweight women showed increased risks for emergency cesarean delivery and postpartum hemorrhage.
- Underweight women had comparable outcomes to normal weight women, with the exception of lower birthweights and increased episiotomy use.
Conclusions:
- Maternal overweight and obesity are independently associated with a wide range of adverse maternal and neonatal outcomes.
- These findings highlight the need for BMI-tailored obstetric care and targeted public health strategies for women of reproductive age.
- Proactive management and prevention are essential to mitigate the risks associated with pregestational BMI extremes.
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