Pre-pregnancy Body Mass Index and the Risk of Adverse Pregnancy Outcome in Two Thousand Type 2 Diabetes Mellitus Bangladeshi Women

Background: The aim of the present study were to evaluate the frequency of maternal complications and adverse fetal outcomes in a group of singleton pregnant women with type 2 diabetes mellitus to compare the outcome in three groups (lean, normal and overweight). Materials and Methods: The women were categorized into three groups: lean <18.5, normal from 18.5 to 24.9 and overweight >25.0-29.9 kg/m2. The effect of pre-pregnancy BMI was analyzed by comparing the frequencies of various outcomes in three BMI groups. The results were expressed as odds ratio (ORs) and the corresponding 95% confidence intervals (CIs) & p values. Results: The risk of late fetal death was consistently increasing with BMI (ORs were 1.2 (0.9-1.7), 1.6 (1.1-2.3) & 2.6 (1.7-3.8) for lean, normal & overweight respectively). The risk of early neonatal death was also higher among women with higher BMI (ORs was 1.6 (1.1-2.3) for overweight). The rate of preeclampsia is higher among women with lean and overweight BMI in compares to normal BMI (the values were 2.5%, 1.8%, & 7.0% for lean, normal & overweight respectively). Hypertensive disorders was also more common among lean (3.8%) and overweight (3.6%) compared to normal (1.6%). The risk of preterm delivery was significantly increased for overweight group (4.2%) and lean (2.4%), as compare to normal. The risk of SGA was significantly more in lean (2.7%) compared to normal weight (1.5%) & overweight group (1.9%). Conclusion: Pre-pregnancy overweight increases the risk of late fetal death and perinatal mortality.