An investigation into utilising gestational body mass index as a screening tool for adverse birth outcomes and maternal morbidities in a group of pregnant women in Khayelitsha

  • Hilary R Davies University of College London
  • Janicke Visser University of Stellenbosch
  • Mark Tomlinson University of Stellenbosch
  • Mary-Jane Rotheram-Borus University of California
  • Conner Gissane St Mary's University College
  • Jessica Harwood University of California
  • Ingrid Le Roux Philani Nutrition Centre
Keywords: Maternal nutritional status, Birth outcomes, Gestational body mass index, Maternal morbidities

Abstract

Objective: The aim of this study was to investigate the ability of the gestational body mass index (BMI) method to screen for adverse birth outcomes and maternal morbidities. Design: This was a substudy of a randomised controlled trial, the Philani Mentor Mothers’ study. Setting and subjects: The Philani Mentor Mothers’ study took place in a peri-urban settlement, Khayelitsha, between 2009 and 2010. Pregnant women living in the area in 2009-2010 were recruited for the study. Outcome measures: Maternal anthropometry (height and weight) and gestational weeks were obtained at baseline to calculate the gestational BMI, which is maternal BMI adjusted for gestational age. Participants were classified into four gestational BMI categories: underweight, normal, overweight and obese. Birth outcomes and maternal morbidities were obtained from clinic cards after the births. Results: Pregnant women were recruited into the study (n = 1 058). Significant differences were found between the different gestational BMI categories and the following birth outcomes: maternal (p-value = 0.019) infant hospital stay (p-value = 0.03), infants staying for over 24 hours in hospital (p-value = 0.001), delivery mode (p-value = 0.001), birthweight (p-value = 0.006), birth length (p-value = 0.007), birth head circumference (p-value = 0.007) and pregnancy-induced hypertension (p-value = 0.001). Conclusion: To the best of our knowledge, this is the first study that has used the gestational BMI method in a peri-urban South African pregnant population. Based on the findings that this method is able to identify unfavourable birth outcomes, it is recommended that it is implemented as a pilot study in selected rural, peri-urban and urban primary health clinics, and that its ease and effectiveness as a screening tool is evaluated. Appropriate medical and nutritional advice can then be given to pregnant women to improve both their own and their infants’ birth-related outcomes and maternal morbidities.

Author Biographies

Hilary R Davies, University of College London
MSc Researcher and RD Division of Human Nutrition Stellenbosch University South Africa
Janicke Visser, University of Stellenbosch
MSc Lecturer and RD Division of Human Nutrition Stellenbosch University South Africa
Mark Tomlinson, University of Stellenbosch
PhD Professor Department of Psychology University of Stellenbosch
Mary-Jane Rotheram-Borus, University of California
PhD Professor Semel Institute and the Department of Psychiatry University of California Los Angeles
Conner Gissane, St Mary's University College
PhD Statistician School of Human and Applied Science St Mary’s University College Twickenham United Kingdom
Jessica Harwood, University of California
MS Statistician Semel Institute and the Department of Psychiatry University of California Los Angeles
Ingrid Le Roux, Philani Nutrition Centre
MD, MPH Philani Child Health and Nutrition Centre Khayelitsha South Africa
Published
2013-03-10
How to Cite
Davies, H., Visser, J., Tomlinson, M., Rotheram-Borus, M.-J., Gissane, C., Harwood, J., & Le Roux, I. (2013). An investigation into utilising gestational body mass index as a screening tool for adverse birth outcomes and maternal morbidities in a group of pregnant women in Khayelitsha. South African Journal of Clinical Nutrition, 26(3), 116-122. Retrieved from http://sajcn.co.za/index.php/SAJCN/article/view/687
Section
Original Research