Association of maternal obesity with fetal and neonatal death: evidence from South and South-East Asian countries

Haque, Rezwanul and Keramat, Syed Afroz and Rahman, Syed Mahbubur and Mustafa, Maimun Ur Rashid and Alam, Khorshed ORCID: https://orcid.org/0000-0003-2232-0745 (2021) Association of maternal obesity with fetal and neonatal death: evidence from South and South-East Asian countries. PLoS One, 16 (9):e0256725. pp. 1-16.

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Abstract

Background
Obesity prevalence is increasing in many countries in the world, including Asia. Maternal obesity is highly associated with fetal and neonatal deaths. This study investigated whether maternal obesity is a risk factor of fetal death (measured in terms of miscarriage and stillbirth) and neonatal mortality in South and South-East Asian countries.

Methods
This cross-sectional study pooled the most recent Demographic and Health Surveys (DHS) from eight South and South-East Asian countries (2014–2018). Multivariate logistic regression was deployed to check the relationships between maternal obesity with fetal and neonatal deaths. Finally, multilevel logistic regression model was employed since the DHS data has a hierarchical structure.

Results
The pooled logistic regression model illustrated that maternal obesity is associated with higher odds of miscarriage (adjusted odds ratio [aOR]: 1.26, 95% CI: 1.20–1.33) and stillbirths (aOR: 1.46, 95% CI: 1.27–1.67) after adjustment of confounders. Children of obese mothers were at 1.18 (aOR: 1.18, 95% CI: 1.08–1.28) times greater risk of dying during the early neonatal period than mothers with a healthy weight. However, whether maternal obesity is statistically a significant risk factor for the offspring’s late neonatal deaths was not confirmed. The significant association between maternal obesity with miscarriage, stillbirth and early neonatal mortality was further confirmed by multilevel logistic regression results.

Conclusion
Maternal obesity in South and South-East Asian countries is associated with a greater risk of fetal and early neonatal deaths. This finding has substantial public health implications. Strategies to prevent and reduce obesity should be developed before planning pregnancy to reduce the fetal and neonatal death burden. Obese women need to deliver at the institutional facility centre that can offer obstetrics and early neonatal care.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Copyright: © 2021 Haque et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Faculty/School / Institute/Centre: Current - Faculty of Business, Education, Law and Arts - School of Business (18 Jan 2021 -)
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Date Deposited: 03 Sep 2021 05:45
Last Modified: 16 Sep 2021 07:55
Uncontrolled Keywords: Obesity, Miscarriage, Stillbirth, Early neonatal mortality, Late neonatal mortality
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111712 Health Promotion
14 Economics > 1402 Applied Economics > 140208 Health Economics
11 Medical and Health Sciences > 1111 Nutrition and Dietetics > 111199 Nutrition and Dietetics not elsewhere classified
Fields of Research (2020): 42 HEALTH SCIENCES > 4206 Public health > 420603 Health promotion
38 ECONOMICS > 3801 Applied economics > 380108 Health economics
32 BIOMEDICAL AND CLINICAL SCIENCES > 3210 Nutrition and dietetics > 321005 Public health nutrition
Socio-Economic Objectives (2008): C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920411 Nutrition
C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified
E Expanding Knowledge > 97 Expanding Knowledge > 970114 Expanding Knowledge in Economics
Socio-Economic Objectives (2020): 20 HEALTH > 2002 Evaluation of health and support services > 200201 Determinants of health
20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200509 Women's and maternal health
28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280108 Expanding knowledge in economics
Identification Number or DOI: https://doi.org/10.1371/journal.pone.0256725
URI: http://eprints.usq.edu.au/id/eprint/43481

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