Association between body mass index and adverse pregnancy outcomes

The prevalence of elevated body mass index (BMI), including overweight and obesity, has been increasing globally, posing significant challenges to maternal and fetal health. This review examines the association between elevated BMI and adverse pregnancy outcomes, emphasizing maternal, fetal, and long-term complications. Elevated BMI in pregnancy is associated with an increased risk of gestational diabetes mellitus, hypertensive disorders, cesarean delivery, and postpartum complications. For the fetus, elevated maternal BMI is linked to an increased risk of macrosomia, preterm birth, congenital anomalies, and stillbirth. Furthermore, these adverse outcomes extend into long-term risks, including a higher likelihood of childhood obesity and metabolic disorders in offspring, as well as persistent obesity and related health issues in mothers. Pathophysiological mechanisms underlying these associations include chronic inflammation, oxidative stress, and hormonal dysregulation. Effective management strategies include preconception counselling, nutritional and exercise interventions, and regular monitoring throughout pregnancy to mitigate these risks. This review underscores the importance of addressing elevated BMI in reproductive-aged women as a critical component of prenatal care to improve pregnancy outcomes and long-term health for both mother and child.