Impacts of maternal obesity on pregnancy and neonatal outcome: A Retrospective cohort study (2018-2022).

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Hind Aljanaahi, Abrar Alsalami, Shabnam Saquib This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6742711/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Maternal Obesity has emerged as a significant global health concern. Obese women in reproductive age carries significant risk of adverse pregnancy and neonatal outcomes. Objectives The study aim to evaluate the point prevalence of maternal obesity and its impact on pregnancy and neonatal outcomes. Methods This was retrospective cohort study done at Dubai and Latifa hospitals in Dubai, United Arab Emirates from 2018–2022. Inclusion criteria were primiparous women, age 20-30years, singleton pregnancy with no past uterine surgeries or pre-existing medical conditions. They were divided into Non-obese (BMI ≤ 30 kg/m²) and Obese ((BMI > 30 kg/m²). Primary outcome assessed were antenatal complication (gestational hypertension, pre-eclampsia, gestational diabetes, preterm premature rupture of membranes), delivery outcome (mode of delivery and blood loss) and neonatal outcome (gestational age at delivery, Apgar score, and neonatal intensive care admission). Results Among the study population, more than half of the pregnant women (53.4%) were classified as obese with a BMI ≥ 30 kg/m². Obesity was significantly associated with adverse pregnancy outcomes, including a higher incidence of gestational hypertension(p = 0.003), gestational diabetes(p = 0.014), pre-eclampsia(p = 0.022), caesarian section(p = 0.001), preterm delivery(p = 0.012) and neonatal intensive care unit (NICU) admissions(p = 0.015). Furthermore, a positive correlation was observed between increasing obesity class and a higher risk of postpartum hemorrhage. Conclusion Our study reveals that in our population 53.4% of women entered their pregnancy with obesity, demonstrating significant pregnancy and neonatal complication. These finding underscore the critical need for targeted intervention to address obesity in pregnancy protocols to optimize maternal and fetal outcomes. Obesity Gestational Hypertension Gestational Diabetes Preeclampsia Primiparous Neonatal complication Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Obesity has emerged as a significant public health concern globally, triggering numerous chronic diseases. The Gulf Cooperation Council (GCC) countries face particularly concerning trends due to demographic changes, population diversity, and lifestyle transitions. The United Arab Emirates National Health Survey Report (2017–2018) revealed an overall obesity prevalence of 27.8%, defined as body mass index (BMI) ≥ 30 kg/m². A 2022 Dubai study showed an obesity rate of 17.8%, with women experiencing higher rates than men (21.6% vs. 16.6%) ( 1 , 2 ). Maternal obesity significantly increases risks for both mother and baby. Obese pregnant women face higher rates of pregnancy-induced hypertension, gestational diabetes, and cesarean deliveries. Their babies often develop macrosomia and require neonatal intensive care unit (NICU) admissions more frequently ( 3 ). Long-term health consequences extend beyond pregnancy, as these mothers face elevated risks of cardiovascular disease, chronic hypertension, and type-2 diabetes. Furthermore, their children often develop obesity and metabolic disorders, creating an intergenerational cycle of health problems ( 4 ). Several studies across the GCC region have investigated factors related to maternal obesity. Al-Rifai et al. conducted a systematic review of maternal and birth cohort studies in GCC countries. Their analysis revealed studies from Saudi Arabia and Oman that linked maternal obesity with adverse outcomes such as fetal macrosomia, gestational diabetes, and higher cesarean section rates ( 5 ). Research shows that maternal obesity, gestational diabetes, and fetal macrosomia increase with age and parity ( 6 ). However there remains a notable gap in the literature regarding studies evaluating maternal obesity as an independent risk factor for pregnancy outcome. The high obesity rates among UAE women of reproductive age, combined with limited local research, highlight the need for this study. We aim to investigate how maternal obesity independently affects pregnancy outcomes in first-time mothers with singleton pregnancies. Objectives: We seek to determine the prevalence of maternal obesity (BMI ≥ 30 kg/m²) among pregnant women in Dubai, UAE. We will compare pregnancy outcomes between non-obese and obese women in this population. Additionally, we will analyze how pregnancy outcomes differ across obesity classes 1, 2, and 3. Material & Methods Study design A retrospective cross sectional cohort study was conducted at Dubai and Latifa Hospital, over a five-year period from 2018 to 2022. The study design evaluated associations between maternal obesity and pregnancy outcomes in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. This study was approved by the Institutional Review Board (IRB) under the protocol number MBRU IRB-2024-43, ensuring compliance with ethical standards for research involving human participants. Study setting The study was conducted in Dubai Hospital and Latifa Hospital, the tertiary care hospitals in Dubai, United Arab Emirates. These hospitals are well-suited to investigate pregnancy outcomes in connection to obesity because they serve a diverse population and have the capacity to manage complicated obstetric cases. Data was retrieved securely and thoroughly across several hospital visits and interventions due to Salama, the centralized electronic health record system in Dubai's medical facilities. Participants and Study Size 33,581 deliveries that were documented in the Salama database over a five-year period (2018–2022) in Dubai's tertiary care hospitals made up the first data source. A sample of 405 women was chosen for this study from this larger dataset including 201 obese women that have a body mass index (BMI) of 30 kg/m2 or higher and 204 non-obese women (BMI < 30 kg/m2). A fair comparison of the pregnancy outcomes of primiparous women who were obese and those who were not was made possible by this sampling strategy. Participants had to be primigravida (first-time pregnant) between the ages of 20 and 30. Among the exclusion criteria were women with any history of uterine surgery or any pre-existing maternal medical conditions such as hypertension or chronic diabetes (see Fig. 1). Study Variables : In order to fully evaluate pregnancy outcomes, this study concentrated on both quantitative and qualitative factors. Maternal obesity BMI was computed using pre-pregnancy height and weight documented in participant's medical records as the main exposure variable. Non-obese and obese participants were split up and the obese group was further separated into three classes: Class 1 (BMI 30.0–34.9 kg/m2), Class 2 (BMI 35.0–39.9 kg/m2), and Class 3 (BMI ≥ 40 kg/m2). Outcome variables were categorized into maternal and fetal outcomes. Maternal outcomes included gestational diabetes (defined as high oral glucose intolerance test, first recognized during pregnancy), gestational hypertension (elevated blood pressure detected after 20 weeks of gestation), preeclampsia, preterm premature rupture of membranes (PPROM, ​the rupture of the amniotic sac (membranes) before the onset of labor and before 37 weeks of gestation), preterm delivery (a delivery before 37 weeks of gestation), blood loss (Postpartum hemorrhage defined as blood loss ≥ 500 ml following normal vaginal delivery and ≥ 1000 ml following cesarean section) and mode of delivery (distinguishing between normal vaginal delivery and cesarean section). Fetal outcomes consisted of gestational age at delivery, abnormal presentation (breech), Apgar score (at 5 minutes after birth), and the need for neonatal intensive care unit (NICU) admission. Potential confounders were also considered, including maternal age (restricted to 20–30 years for this study), participants (restricted to primigravida status), and gestational age at delivery. Controlling for these variables helped to isolate the effect of maternal obesity on pregnancy outcomes while reducing potential biases in outcome interpretation. Data sources/measurement Data was gathered from the Salama system, Dubai's central healthcare database that aggregates electronic medical records from several Dubai Health facilities. This database made it possible to view each participant's complete medical records including demographic data, medical history, pregnancy progress and documented results. Qualitative information from clinical notes, provider observations, and patient narratives was utilized to confirm conditions like preeclampsia and gestational hypertension, while quantitative information like BMI and gestational age was taken straight from the records. All information was arranged in Microsoft Excel and data extraction was standardized before being imported into IBM SPSS Statistics (version 25.0) for analysis. Statistical methods In order to summarize participant outcomes, statistical analysis and descriptive statistics were utilized, which gave percentages for categorical variables and mean and standard deviation values for continuous variables. Group comparisons were conducted using the t-test to compare continuous outcomes between the non-obese and obese groups, such as BMI, and the chi-square test to evaluate associations for categorical variables, such as NICU admissions and mode of delivery. At a p-value of < 0.05, the cutoff point for determining statistical significance was established. The relationships between maternal obesity and pregnancy outcomes were also investigated using regression models, which were utilized to account for potential confounders. In order to be more specific in evaluating outcomes, subgroup analyses for various classes of obesity were carried out to look at differences in outcomes as the severity of obesity increased. To minimize information bias, standardized data collection methods were used and cross-referenced information within the Salama system. By using STROBE, the study conformed to established standards for observational research and minimized reporting bias. Results Prevalence of Maternal Obesity During our study period, 33,581 deliveries occurred in Dubai and Latifa Hospitals. Out of them, 17,939 women had a BMI of 30 kg/m2 or above, giving the point prevalence of obesity 53.4%. Figure 2 shows the percentage of non-obese and obese women with different classification in the study group Comparison of Pregnancy and Neonatal Outcomes Across Obesity Status Maternal Outcomes : Antenatal Outcomes Obese women had a significantly higher incidence of gestational hypertension (GH) compared to non-obese women (7.5% vs. 1.5%, p = .003). Similarly, the prevalence of gestational diabetes (GD) was significantly greater in the obese group (21.4% vs. 12.3%, p = .014). Preeclampsia was also more frequent among obese women (7.5% vs. 2.5%, p = .022). There were no statistically significant differences between groups in the rates of preterm premature rupture of membranes (PPROM; 4.5% vs. 3.4%, p = .589) or breech presentation (6.5% vs. 5.4%, p = .640). (Table − 1) Intrapartum Outcomes : Obesity was associated with significant differences in mode of delivery. A higher proportion of obese women delivered by cesarean section (CS) compared to non-obese women (42% vs. 26%, p = .001), while normal vaginal delivery (NVD) was more common in the non-obese group (74% vs. 57.7%). Rates of postpartum hemorrhage (PPH), whether after NVD (> 500ml: 5% vs. 2.4%) or CS (> 1000ml: 4% vs. 2%), were not significantly different between the groups (p = .884). (Table − 1) Neonatal Outcomes Preterm delivery (< 37 weeks) occurred more frequently among infants born to obese mothers compared to those born to non-obese mothers (18.4% vs. 10.3%, p = .012). Admission to the neonatal intensive care unit (NICU) was also significantly higher in the obese group (24.9% vs. 15.2%, p = .015). There was no significant difference in Apgar scores < 7 at 5 minutes (1% in obese vs. 0.5% in non-obese, p = .554). (Table − 1) Comparison of maternal and fetal outcome by Obesity Class : Maternal Outcomes : Antenatal Outcomes The incidence of gestational hypertension (GH) varied among the groups, with the highest rate in Class 2 (13.0%), followed by Class 3 (4.8%) and Class 1 (4.3%), though the difference was not statistically significant (p = .093). Rates of gestational diabetes (GD) were relatively similar across groups, 21.4% in Class 1, 17.4% in Class 2, and 25.8% in Class 3 (p = .503). Preeclampsia occurred in 7.1% of Class 1, 5.8% of Class 2, and 7.5% of Class 3 women (p = .695). Preterm premature rupture of membranes (PPROM) was also not significantly different, occurring in 2.9%, 4.3%, and 6.5% of Class 1, 2, and 3, respectively (p = .607). (Table-2) Intrapartum Outcomes Mode of delivery did not differ significantly among obesity classes. Normal vaginal delivery (NVD) was most common in Class 1 (61.4%), followed by Class 2 (58%) and Class 3 (53.2%) (p = .635). Conversely, cesarean section (CS) rates were highest in Class 3 (46.8%), followed by Class 2 (42%) and Class 1 (38.6%) (Fig. 3 ). Postpartum hemorrhage (PPH) rates after NVD were highest in Class 3 (8%), with lower rates in Class 1 (4%) and Class 2 (2.8%). Similarly, PPH following CS occurred in 8% of Class 3, 4.3% of Class 2, and 1.4% of Class 1; however, none of these differences reached statistical significance (p = .562) (Fig. 4 ). Neonatal Outcomes Preterm delivery (< 37 weeks) occurred in 17.1% of Class 1, 23.2% of Class 2, and 14.5% of Class 3 births (p = .417). NICU admissions ranged from 22.9% in Class 1 to 23.2% in Class 2 and 29% in Class 3 (p = .660). Apgar scores < 7 at 5 minutes were rare across all groups, with only one case each in Class 2 and Class 3, and none in Class 1 (p = .580).(Table-2) Discussion The global prevalence of maternal obesity has reached critical proportions demonstrating an unprecedented upwards trajectory. Current epidemiological data indicates a global maternal obesity rate of 20.9% with projections suggesting an increase to 23.3% by 2030. ( 7 ). According to the Euro-peristat and WHO database, the prevalence of maternal obesity in European nations ranges from 7% − 25% ( 8 ). In Northern American, the rate varies significantly from 18.5–38.3% while in Canadian population approximately 18% ( 9 – 11 ). Limited studies from the Middle East and sub-Saharan regions have documented substantial rate, with oman reporting 34% and Morocco 41% maternal obesity prevalence. ( 12 , 13 ). In our cohort of pregnant women of 33,581, between 2018 to 2022, we observed the point prevalence of maternal obesity at 53.4%, which is substantially high than other nations. This finding underscores the magnitude of the obesity epidemic among pregnant women in our region. Several studies have repeatedly shown a high correlation among maternal obesity and unfavorable pregnancy outcomes, both across the world and in the GCC. For instance, studies have shown that compared to women of normal weight, obese women face a significantly higher risk of complications such as preeclampsia, cesarean delivery (including repeat cesareans), fetal macrosomia (birth weight ≥ 4000 g), and neonatal intensive care unit (NICU) admissions ( 14 ). This correlates with our study results, which showed a great correlation between these outcomes and maternal obesity. The documented association between maternal obesity and elevated birth weight was in addition supported by Otero-Naveiro et al. ( 15 ), who observed that babies born to obese moms had an average birth weight that was 161.21 g higher than those born to normal-weight moms. Simko et al. ( 16 ) observed that overweight and obese women had a significantly higher risk of developing gestational hypertension (adjusted odds ratio (AOR) = 15.3 for obesity), preeclampsia (AOR = 13.2 for obesity), and gestational diabetes mellitus (GDM) (AOR = 2.4 for obesity). Additionally, they discovered that obese women had a greater rate of cesarean sections, which is consistent with our findings that obese moms were more likely to have a cesarean delivery. Similar results have been seen in the GCC. Al-Rifai et al. ( 5 ) discovered that obese women in Saudi Arabia were at a higher risk of macrosomia (adjusted relative risk [aRR] = 1.15), as well as cesarean delivery (aRR = 1.21). These results are supported by our research, which also shows how maternal obesity significantly affects these pregnancy outcomes. According to Zutshi et al. ( 13 ) obese women in Oman had significantly higher rates of fetal macrosomia (relative risk [RR] = 2.71), gestational diabetes (RR = 2.23), gestational hypertension (RR = 3.04), and cesarean sections (RR = 1.48). Consistent with our study’s higher cesarean delivery rates, a study conducted in Abu Dhabi, United Arab Emirates, also determined that obese mothers had been much more likely to deliver by means of cesarean section (odds ratio [OR] = 1. 95; 95% CI 1.27–2.96) ( 17 ). When taken as a whole, those studies highlight the robust correlation among maternal obesity and a number of adverse pregnancy results. Maternal obesity is an established factor for challenges for both mother and infant, ranging from macrosomia and cesarean births to preeclampsia and gestational diabetes. Inside the GCC, where obesity rates are growing at an alarming trend, our findings emphasize the pressing need for early screening, preventive interventions, and control strategies to cope with pregnancy-related obesity. Strengths, Limitations, & Generalizability The study utilizes a large retrospective cohort over five years to enhance data reliability. It uses extensive medical records from Dubai healthcare facilities to record demographics, disease classification, and pregnancy outcomes. By removing confounding variables from prior pregnancies, the study evaluates obesity effects on primiparous women, enhancing the precision of relationships between maternal obesity and pregnancy outcomes. The study, while beneficial, has several drawbacks. It relies on pre-existing medical records, potentially leading to information bias. The restricted demographic of women in Dubai may not accurately represent the Emirati or regional population, reducing inclusiveness. Additionally, the study may not fully account for confounding variables like socioeconomic status or lifestyle factors affecting pregnancy outcomes. Areas of future research : In order to comprehend long-term effects such as modifications in metabolism and lifestyle future studies should track expectant mothers from conception to delivery. Additionally factors like eating habits, physical activity and socioeconomic status could be taken into account. Furthermore, research on the effectiveness of particular interventions like dietary recommendations and the early detection of gestational diabetes may yield important data for public health policy and clinical practice. To assess the impact of these interventions randomized controlled trials might be required. By improving the best practices for managing maternal obesity in the United Arab Emirates and comparable contexts these studies could enhance the health outcomes for both mothers and newborns. Conclusion The study highlights the significant impact of maternal weight on pregnancy outcomes for first-time mothers in Dubai, UAE. Maternal obesity is linked to pre-eclampsia, cesarean sections, gestational hypertension, gestational diabetes, and infant complications, including NICU admissions. Given the 53.4% obesity rate, specific public health strategies and medical interventions are crucial. The study aims to address the knowledge gap in the United Arab Emirates regarding maternal obesity, a global health issue, by providing region-specific data that can guide healthcare strategies and improve management. It emphasizes the importance of early screening and close monitoring of obese pregnant women to reduce complications during pregnancy and delivery. The study suggests further research in the Gulf Cooperation Council and the UAE on maternal obesity risks for expectant mothers and their unborn children. It suggests that future studies can help develop medical measures and political strategies to combat the rising rate of maternal obesity, necessitating changes in healthcare policies and education. Declarations Ethical Approval and consent to participate- There was NO direct contact with the patient, data was collected from the electronic device . This study was approved by the Institutional Review Board (IRB) under the protocol number MBRU IRB-2024-43 (Mohammed Bin Rashid University Institutional Review Board, Dubai) ensuring compliance with ethical standards for research involving human participants. Consent to participate was waived by an Institutional Review Board (IRB) - MBRU IRB-2024-43 Consent for publication- Not applicable Availability of data and materials- Due to patients’confidentiality and ethical restrictions, we are unable to share the data. The data will be available on request from the author. Our study adhered to the Declaration of Helsinki Competing interest- Not applicable Funding – No applicable Authors contributions – A- Hind Aljanaahi B- Abrar Alsalami C- Dr Shabnam Saquib 1- Design of the work- C , 2-Analysis OR interpretation of data- A.B.C 3- The creation of new software used in the work - A.B 4- Drafted the work or substantively revised it - A.B.C Acknowledgement: We would like to convey our genuine appreciation to Dr. Jeyaseelan Lakshmanan, Professor of Biostatistics, Mohamed Bin Rashid University of medical and health sciences ( MBRU) and Dr Marwan Zidan, Statistician, Dubai Health (DH) for statistic evaluation and guidance throughout this project. References UAE National Health Survey Report 2017–2018 . Ministry of Health and Prevention, United Arab Emirates; 2018. 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Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis. Syst Rev . 2020;9(1):14. doi:10.1186/s13643-020-1277-0 BioMed Central Gupta S, Kapoor S. Independent and combined association of parity and short pregnancy with obesity and weight change among Indian women. Health . 2012;4(5):271–6. doi:10.4236/health.2012.45044 PMC Kent L, McGirr M, Eastwood K-A. Global trends in prevalence of maternal overweight and obesity: A systematic review and meta-analysis of routinely collected data retrospective cohorts. Int J Popul Data Sci . 2024;9(2). doi:10.23889/ijpds.v9i2.2401 PopData Science Journal Devlieger R, Benhalima K, Damm P, Van Assche A, Mathieu C, Mahmood T, et al. Maternal obesity in Europe: where do we stand and how to move forward? A scientific paper commissioned by the European Board and College of Obstetrics and Gynaecology (EBCOG). Eur J Obstet Gynecol Reprod Biol . 2016;201:203–8. doi:10.1016/j.ejogrb.2016.04.005 Galtier-Dereure F, Boegner C, Bringer J. Obesity and pregnancy: complications and cost. Am J Clin Nutr . 2000;71(5 Suppl):1242S–8S. doi:10.1093/ajcn/71.5.1242s ResearchGate+1PubMed+1 Berger H, Melamed N, Murray-Davis B, Hasan H, Mawjee K, Barrett J, et al. Prevalence of pre-pregnancy diabetes, obesity, and hypertension in Canada. J Obstet Gynaecol Can . 2019;41(11):1579–88.e2. doi:10.1016/j.jogc.2019.03.034 Singh GK, DiBari JN, Lee H. Prevalence and social and built environmental determinants of maternal prepregnancy obesity in 68 major metropolitan cities of the United States, 2013–2016. J Environ Public Health . 2021;2021:6650956. doi:10.1155/2021/6650956 Wiley Online Library Fatima T, Fatima Zahra L, Fatima B, Nadia H, Hassan A, Amina B. Study of the prevalence of obesity and its association with maternal and neonatal characteristics and morbidity profile in a population of Moroccan pregnant women. J Nutr Metab . 2021;2021:6692312. doi:10.1155/2021/6692312 Zutshi A, Santhosh J, Sheikh J, Naeem F, Al-Hamedi A, Khan S, et al. Implications of early pregnancy obesity on maternal, fetal and neonatal health: retrospective cohort study from Oman. Sultan Qaboos Univ Med J . 2018;18(1):e47–53. doi:10.18295/squmj.2018.18.01.009 Melchor I, Burgos J, Del Campo A, Aiartzaguena A, Gutiérrez J, Melchor JC. Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study. J Perinat Med . 2019;47(6):625–30. doi:10.1515/jpm-2019-0103 De Gruyter Brill Otero-Naveiro A, Gómez-Fernández C, Álvarez-Fernández R, Pérez-López M, Paz-Fernández E. Maternal and fetal outcomes during pregnancy and puerperium in obese and overweight pregnant women: a cohort study. Arch Gynecol Obstet . 2021;304(5):1205–12. doi:10.1007/s00404-021-06061-3 Simko M, Totka A, Vondrova D, Samohyl M, Jurkovicova J, Trnka M, et al. Maternal body mass index and gestational weight gain and their association with pregnancy complications and perinatal conditions. Int J Environ Res Public Health . 2019;16(10):1751. doi:10.3390/ijerph16101751 Taha Z, Hassan AA, Papandreou D. Epidemiology of pre-pregnancy body mass index (BMI) among mothers in Abu Dhabi, the United Arab Emirates. Front Glob Womens Health . 2022;3:893808. doi:10.3389/fgwh.2022.893808 Tables Tables 1 and 2 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Tables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6742711","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":483707988,"identity":"6dc2916d-2908-4c13-a838-f94124b16a91","order_by":0,"name":"Hind Aljanaahi","email":"","orcid":"","institution":"Mohammed Bin Rashid University of Medical and Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Hind","middleName":"","lastName":"Aljanaahi","suffix":""},{"id":483707989,"identity":"f44eafb3-b11f-46b0-b19d-be52147d06c1","order_by":1,"name":"Abrar Alsalami","email":"","orcid":"","institution":"Mohammed Bin Rashid University of Medical and Health Sciences","correspondingAuthor":false,"prefix":"","firstName":"Abrar","middleName":"","lastName":"Alsalami","suffix":""},{"id":483707990,"identity":"65951b37-d35c-43dd-90a8-3fbb3e662a3c","order_by":2,"name":"Shabnam Saquib","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA80lEQVRIiWNgGAWjYDACCQY2OPswQwWQZGZuIEXLGZAWRhK0MDO2gSgCWuRnNz97XFCzzZ6/PcfwcOG82mj+dqCWHxXbcGoxuHPM3HjGsduJM868MTg8c9vx3BmHGRsYe87cxq1FIsFMmoftdgLDjRyDw7zbjuU2ALUAXYhbi/yM9G/SPP9u28uDtcw5ljufkBag4WbSvG23GTeAtTTU5G4gpMXgRk65MW/f7cSNZ54VHJ5x7EDuRqCWg/j8AnTYtsc8327byx1P3vy5oKYud975wwcf/KjA4zAESAARh8HMA8Soh2mpI1LxKBgFo2AUjCQAANtMYX70KkpZAAAAAElFTkSuQmCC","orcid":"","institution":"Mohammed Bin Rashid University of Medical and Health Sciences","correspondingAuthor":true,"prefix":"","firstName":"Shabnam","middleName":"","lastName":"Saquib","suffix":""}],"badges":[],"createdAt":"2025-05-25 08:53:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6742711/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6742711/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86660095,"identity":"410c4f97-5f01-46e4-86b6-35987d8db894","added_by":"auto","created_at":"2025-07-14 10:33:49","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":54935,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6742711/v1/59468f0eb83416e57f0d7dc1.png"},{"id":86660097,"identity":"da409b4b-4203-4e8d-a53a-1a3331e3b715","added_by":"auto","created_at":"2025-07-14 10:33:49","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":28191,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of obesity classes and non-obese participants in the study population. Non-obese (BMI \u0026lt;30.0 kg/m²), Obesity Class 1 (BMI 30.0–34.9 kg/m²), Obesity Class 2 (BMI 35.0–39.9 kg/m²), Obesity Class 3 (BMI ≥40.0 kg/m²).\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6742711/v1/63ff162f0c0699501f4b8b08.png"},{"id":86658427,"identity":"e18878f1-a1f2-4dfd-8ccf-43faadceb0e2","added_by":"auto","created_at":"2025-07-14 10:25:49","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":31516,"visible":true,"origin":"","legend":"\u003cp\u003eMode of Delivery and Maternal Obesity Class. NVD, Normal Vaginal Delivery; CS, Cesarean Section.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-6742711/v1/594c407f4cb66ba1ee7c7092.png"},{"id":86658467,"identity":"d618f6e3-e332-42cb-bd07-8e0aede0aea9","added_by":"auto","created_at":"2025-07-14 10:25:50","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":29246,"visible":true,"origin":"","legend":"\u003cp\u003eRelationship between Obesity Status and Class—Non-obese, Class 1, Class 2, and Class 3 and Blood Loss During Delivery in mL.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-6742711/v1/af10cc12e616fabff6553006.png"},{"id":87587940,"identity":"f05f69ae-9706-40d1-a008-a042547fbd9e","added_by":"auto","created_at":"2025-07-25 14:09:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":895413,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6742711/v1/dc06e016-3ee9-4eae-bfbe-598144390d8e.pdf"},{"id":86658429,"identity":"a5cf0d94-4aba-4f6f-9ba6-19025e4873b5","added_by":"auto","created_at":"2025-07-14 10:25:49","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":44751,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-6742711/v1/a586d91ce9b9e30c7dad264f.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Impacts of maternal obesity on pregnancy and neonatal outcome: A Retrospective cohort study (2018-2022).","fulltext":[{"header":"Introduction","content":"\u003cp\u003eObesity has emerged as a significant public health concern globally, triggering numerous chronic diseases. The Gulf Cooperation Council (GCC) countries face particularly concerning trends due to demographic changes, population diversity, and lifestyle transitions. The United Arab Emirates National Health Survey Report (2017–2018) revealed an overall obesity prevalence of 27.8%, defined as body mass index (BMI) ≥ 30 kg/m². A 2022 Dubai study showed an obesity rate of 17.8%, with women experiencing higher rates than men (21.6% vs. 16.6%) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMaternal obesity significantly increases risks for both mother and baby. Obese pregnant women face higher rates of pregnancy-induced hypertension, gestational diabetes, and cesarean deliveries. Their babies often develop macrosomia and require neonatal intensive care unit (NICU) admissions more frequently (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Long-term health consequences extend beyond pregnancy, as these mothers face elevated risks of cardiovascular disease, chronic hypertension, and type-2 diabetes. Furthermore, their children often develop obesity and metabolic disorders, creating an intergenerational cycle of health problems (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSeveral studies across the GCC region have investigated factors related to maternal obesity. Al-Rifai et al. conducted a systematic review of maternal and birth cohort studies in GCC countries. Their analysis revealed studies from Saudi Arabia and Oman that linked maternal obesity with adverse outcomes such as fetal macrosomia, gestational diabetes, and higher cesarean section rates (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Research shows that maternal obesity, gestational diabetes, and fetal macrosomia increase with age and parity (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). However there remains a notable gap in the literature regarding studies evaluating maternal obesity as an independent risk factor for pregnancy outcome.\u003c/p\u003e\u003cp\u003eThe high obesity rates among UAE women of reproductive age, combined with limited local research, highlight the need for this study. We aim to investigate how maternal obesity independently affects pregnancy outcomes in first-time mothers with singleton pregnancies.\u003c/p\u003e\u003cp\u003eObjectives: We seek to determine the prevalence of maternal obesity (BMI ≥ 30 kg/m²) among pregnant women in Dubai, UAE. We will compare pregnancy outcomes between non-obese and obese women in this population. Additionally, we will analyze how pregnancy outcomes differ across obesity classes 1, 2, and 3.\u003c/p\u003e"},{"header":"Material \u0026 Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eA retrospective cross sectional cohort study was conducted at Dubai and Latifa Hospital, over a five-year period from 2018 to 2022. The study design evaluated associations between maternal obesity and pregnancy outcomes in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. This study was approved by the Institutional Review Board (IRB) under the protocol number MBRU IRB-2024-43, ensuring compliance with ethical standards for research involving human participants.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eStudy setting\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e The study was conducted in Dubai Hospital and Latifa Hospital, the tertiary care hospitals in Dubai, United Arab Emirates. These hospitals are well-suited to investigate pregnancy outcomes in connection to obesity because they serve a diverse population and have the capacity to manage complicated obstetric cases. Data was retrieved securely and thoroughly across several hospital visits and interventions due to Salama, the centralized electronic health record system in Dubai's medical facilities.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eParticipants and Study Size\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e33,581 deliveries that were documented in the Salama database over a five-year period (2018–2022) in Dubai's tertiary care hospitals made up the first data source. A sample of 405 women was chosen for this study from this larger dataset including 201 obese women that have a body mass index (BMI) of 30 kg/m2 or higher and 204 non-obese women (BMI \u0026lt; 30 kg/m2). A fair comparison of the pregnancy outcomes of primiparous women who were obese and those who were not was made possible by this sampling strategy. Participants had to be primigravida (first-time pregnant) between the ages of 20 and 30. Among the exclusion criteria were women with any history of uterine surgery or any pre-existing maternal medical conditions such as hypertension or chronic diabetes (see Fig.\u0026nbsp;1).\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Variables\u003c/b\u003e: In order to fully evaluate pregnancy outcomes, this study concentrated on both quantitative and qualitative factors. Maternal obesity BMI was computed using pre-pregnancy height and weight documented in participant's medical records as the main exposure variable. Non-obese and obese participants were split up and the obese group was further separated into three classes: Class 1 (BMI 30.0–34.9 kg/m2), Class 2 (BMI 35.0–39.9 kg/m2), and Class 3 (BMI ≥ 40 kg/m2). Outcome variables were categorized into maternal and fetal outcomes. Maternal outcomes included gestational diabetes (defined as high oral glucose intolerance test, first recognized during pregnancy), gestational hypertension (elevated blood pressure detected after 20 weeks of gestation), preeclampsia, preterm premature rupture of membranes (PPROM, ​the rupture of the amniotic sac (membranes) before the onset of labor and before 37 weeks of gestation), preterm delivery (a delivery before 37 weeks of gestation), blood loss (Postpartum hemorrhage defined as blood loss ≥ 500 ml following normal vaginal delivery and ≥ 1000 ml following cesarean section) and mode of delivery (distinguishing between normal vaginal delivery and cesarean section). Fetal outcomes consisted of gestational age at delivery, abnormal presentation (breech), Apgar score (at 5 minutes after birth), and the need for neonatal intensive care unit (NICU) admission. Potential confounders were also considered, including maternal age (restricted to 20–30 years for this study), participants (restricted to primigravida status), and gestational age at delivery. Controlling for these variables helped to isolate the effect of maternal obesity on pregnancy outcomes while reducing potential biases in outcome interpretation.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eData sources/measurement\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eData was gathered from the Salama system, Dubai's central healthcare database that aggregates electronic medical records from several Dubai Health facilities. This database made it possible to view each participant's complete medical records including demographic data, medical history, pregnancy progress and documented results. Qualitative information from clinical notes, provider observations, and patient narratives was utilized to confirm conditions like preeclampsia and gestational hypertension, while quantitative information like BMI and gestational age was taken straight from the records. All information was arranged in Microsoft Excel and data extraction was standardized before being imported into IBM SPSS Statistics (version 25.0) for analysis.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eStatistical methods\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eIn order to summarize participant outcomes, statistical analysis and descriptive statistics were utilized, which gave percentages for categorical variables and mean and standard deviation values for continuous variables. Group comparisons were conducted using the t-test to compare continuous outcomes between the non-obese and obese groups, such as BMI, and the chi-square test to evaluate associations for categorical variables, such as NICU admissions and mode of delivery. At a p-value of \u0026lt; 0.05, the cutoff point for determining statistical significance was established. The relationships between maternal obesity and pregnancy outcomes were also investigated using regression models, which were utilized to account for potential confounders. In order to be more specific in evaluating outcomes, subgroup analyses for various classes of obesity were carried out to look at differences in outcomes as the severity of obesity increased. To minimize information bias, standardized data collection methods were used and cross-referenced information within the Salama system. By using STROBE, the study conformed to established standards for observational research and minimized reporting bias.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003ePrevalence of Maternal Obesity\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eDuring our study period, 33,581 deliveries occurred in Dubai and Latifa Hospitals. Out of them, 17,939 women had a BMI of 30 kg/m2 or above, giving the point prevalence of obesity 53.4%. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the percentage of non-obese and obese women with different classification in the study group\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison of Pregnancy and Neonatal Outcomes Across Obesity Status\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eMaternal Outcomes\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAntenatal Outcomes\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eObese women had a significantly higher incidence of gestational hypertension (GH) compared to non-obese women (7.5% vs. 1.5%, p = .003). Similarly, the prevalence of gestational diabetes (GD) was significantly greater in the obese group (21.4% vs. 12.3%, p = .014). Preeclampsia was also more frequent among obese women (7.5% vs. 2.5%, p = .022). There were no statistically significant differences between groups in the rates of preterm premature rupture of membranes (PPROM; 4.5% vs. 3.4%, p = .589) or breech presentation (6.5% vs. 5.4%, p = .640). (Table − 1)\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eIntrapartum Outcomes\u003c/b\u003e: Obesity was associated with significant differences in mode of delivery. A higher proportion of obese women delivered by cesarean section (CS) compared to non-obese women (42% vs. 26%, p = .001), while normal vaginal delivery (NVD) was more common in the non-obese group (74% vs. 57.7%). Rates of postpartum hemorrhage (PPH), whether after NVD (\u0026gt; 500ml: 5% vs. 2.4%) or CS (\u0026gt; 1000ml: 4% vs. 2%), were not significantly different between the groups (p = .884). (Table − 1)\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNeonatal Outcomes\u003c/strong\u003e\u003c/p\u003e\u003cp\u003ePreterm delivery (\u0026lt; 37 weeks) occurred more frequently among infants born to obese mothers compared to those born to non-obese mothers (18.4% vs. 10.3%, p = .012). Admission to the neonatal intensive care unit (NICU) was also significantly higher in the obese group (24.9% vs. 15.2%, p = .015). There was no significant difference in Apgar scores \u0026lt; 7 at 5 minutes (1% in obese vs. 0.5% in non-obese, p = .554). (Table − 1)\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison of maternal and fetal outcome by Obesity Class\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cb\u003eMaternal Outcomes\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAntenatal Outcomes\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThe incidence of gestational hypertension (GH) varied among the groups, with the highest rate in Class 2 (13.0%), followed by Class 3 (4.8%) and Class 1 (4.3%), though the difference was not statistically significant (p = .093). Rates of gestational diabetes (GD) were relatively similar across groups, 21.4% in Class 1, 17.4% in Class 2, and 25.8% in Class 3 (p = .503). Preeclampsia occurred in 7.1% of Class 1, 5.8% of Class 2, and 7.5% of Class 3 women (p = .695). Preterm premature rupture of membranes (PPROM) was also not significantly different, occurring in 2.9%, 4.3%, and 6.5% of Class 1, 2, and 3, respectively (p = .607). (Table-2)\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eIntrapartum Outcomes\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eMode of delivery did not differ significantly among obesity classes. Normal vaginal delivery (NVD) was most common in Class 1 (61.4%), followed by Class 2 (58%) and Class 3 (53.2%) (p = .635). Conversely, cesarean section (CS) rates were highest in Class 3 (46.8%), followed by Class 2 (42%) and Class 1 (38.6%) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Postpartum hemorrhage (PPH) rates after NVD were highest in Class 3 (8%), with lower rates in Class 1 (4%) and Class 2 (2.8%). Similarly, PPH following CS occurred in 8% of Class 3, 4.3% of Class 2, and 1.4% of Class 1; however, none of these differences reached statistical significance (p = .562) (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eNeonatal Outcomes\u003c/strong\u003e\u003c/p\u003e\u003cp\u003ePreterm delivery (\u0026lt; 37 weeks) occurred in 17.1% of Class 1, 23.2% of Class 2, and 14.5% of Class 3 births (p = .417). NICU admissions ranged from 22.9% in Class 1 to 23.2% in Class 2 and 29% in Class 3 (p = .660). Apgar scores \u0026lt; 7 at 5 minutes were rare across all groups, with only one case each in Class 2 and Class 3, and none in Class 1 (p = .580).(Table-2)\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe global prevalence of maternal obesity has reached critical proportions demonstrating an unprecedented upwards trajectory. Current epidemiological data indicates a global maternal obesity rate of 20.9% with projections suggesting an increase to 23.3% by 2030. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). According to the Euro-peristat and WHO database, the prevalence of maternal obesity in European nations ranges from 7% − 25% (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). In Northern American, the rate varies significantly from 18.5–38.3% while in Canadian population approximately 18% (\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e–\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Limited studies from the Middle East and sub-Saharan regions have documented substantial rate, with oman reporting 34% and Morocco 41% maternal obesity prevalence. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). In our cohort of pregnant women of 33,581, between 2018 to 2022, we observed the point prevalence of maternal obesity at 53.4%, which is substantially high than other nations. This finding underscores the magnitude of the obesity epidemic among pregnant women in our region.\u003c/p\u003e\u003cp\u003eSeveral studies have repeatedly shown a high correlation among maternal obesity and unfavorable pregnancy outcomes, both across the world and in the GCC. For instance, studies have shown that compared to women of normal weight, obese women face a significantly higher risk of complications such as preeclampsia, cesarean delivery (including repeat cesareans), fetal macrosomia (birth weight ≥ 4000 g), and neonatal intensive care unit (NICU) admissions (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). This correlates with our study results, which showed a great correlation between these outcomes and maternal obesity. The documented association between maternal obesity and elevated birth weight was in addition supported by Otero-Naveiro et al. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), who observed that babies born to obese moms had an average birth weight that was 161.21 g higher than those born to normal-weight moms.\u003c/p\u003e\u003cp\u003eSimko et al. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) observed that overweight and obese women had a significantly higher risk of developing gestational hypertension (adjusted odds ratio (AOR) = 15.3 for obesity), preeclampsia (AOR = 13.2 for obesity), and gestational diabetes mellitus (GDM) (AOR = 2.4 for obesity). Additionally, they discovered that obese women had a greater rate of cesarean sections, which is consistent with our findings that obese moms were more likely to have a cesarean delivery.\u003c/p\u003e\u003cp\u003eSimilar results have been seen in the GCC. Al-Rifai et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) discovered that obese women in Saudi Arabia were at a higher risk of macrosomia (adjusted relative risk [aRR] = 1.15), as well as cesarean delivery (aRR = 1.21). These results are supported by our research, which also shows how maternal obesity significantly affects these pregnancy outcomes. According to Zutshi et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) obese women in Oman had significantly higher rates of fetal macrosomia (relative risk [RR] = 2.71), gestational diabetes (RR = 2.23), gestational hypertension (RR = 3.04), and cesarean sections (RR = 1.48). Consistent with our study’s higher cesarean delivery rates, a study conducted in Abu Dhabi, United Arab Emirates, also determined that obese mothers had been much more likely to deliver by means of cesarean section (odds ratio [OR] = 1. 95; 95% CI 1.27–2.96) (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhen taken as a whole, those studies highlight the robust correlation among maternal obesity and a number of adverse pregnancy results. Maternal obesity is an established factor for challenges for both mother and infant, ranging from macrosomia and cesarean births to preeclampsia and gestational diabetes. Inside the GCC, where obesity rates are growing at an alarming trend, our findings emphasize the pressing need for early screening, preventive interventions, and control strategies to cope with pregnancy-related obesity.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStrengths, Limitations, \u0026amp; Generalizability\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study utilizes a large retrospective cohort over five years to enhance data reliability. It uses extensive medical records from Dubai healthcare facilities to record demographics, disease classification, and pregnancy outcomes. By removing confounding variables from prior pregnancies, the study evaluates obesity effects on primiparous women, enhancing the precision of relationships between maternal obesity and pregnancy outcomes.\u003c/p\u003e\u003cp\u003eThe study, while beneficial, has several drawbacks. It relies on pre-existing medical records, potentially leading to information bias. The restricted demographic of women in Dubai may not accurately represent the Emirati or regional population, reducing inclusiveness. Additionally, the study may not fully account for confounding variables like socioeconomic status or lifestyle factors affecting pregnancy outcomes.\u003c/p\u003e\u003cp\u003e\u003cb\u003eAreas of future research\u003c/b\u003e:\u003c/p\u003e\u003cp\u003eIn order to comprehend long-term effects such as modifications in metabolism and lifestyle future studies should track expectant mothers from conception to delivery. Additionally factors like eating habits, physical activity and socioeconomic status could be taken into account. Furthermore, research on the effectiveness of particular interventions like dietary recommendations and the early detection of gestational diabetes may yield important data for public health policy and clinical practice. To assess the impact of these interventions randomized controlled trials might be required. By improving the best practices for managing maternal obesity in the United Arab Emirates and comparable contexts these studies could enhance the health outcomes for both mothers and newborns.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study highlights the significant impact of maternal weight on pregnancy outcomes for first-time mothers in Dubai, UAE. Maternal obesity is linked to pre-eclampsia, cesarean sections, gestational hypertension, gestational diabetes, and infant complications, including NICU admissions. Given the 53.4% obesity rate, specific public health strategies and medical interventions are crucial.\u003c/p\u003e\u003cp\u003e The study aims to address the knowledge gap in the United Arab Emirates regarding maternal obesity, a global health issue, by providing region-specific data that can guide healthcare strategies and improve management. It emphasizes the importance of early screening and close monitoring of obese pregnant women to reduce complications during pregnancy and delivery.\u003c/p\u003e\u003cp\u003eThe study suggests further research in the Gulf Cooperation Council and the UAE on maternal obesity risks for expectant mothers and their unborn children. It suggests that future studies can help develop medical measures and political strategies to combat the rising rate of maternal obesity, necessitating changes in healthcare policies and education.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval and consent to participate-\u0026nbsp;\u003c/strong\u003eThere was NO direct contact with the patient, data was collected from the electronic device\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eThis study was approved by the Institutional Review Board (IRB) under the protocol number \u003cstrong\u003eMBRU IRB-2024-43 (Mohammed Bin Rashid University Institutional Review Board, Dubai)\u003c/strong\u003e ensuring compliance with ethical standards for research involving human participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate was waived by an Institutional Review Board (IRB) - MBRU IRB-2024-43\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication- Not applicable\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials-\u003c/strong\u003e Due to patients’confidentiality and ethical restrictions, we are unable to share the data. The data will be available on request from the author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOur study adhered to the Declaration of Helsinki\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest-\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding –\u0026nbsp;\u003c/strong\u003eNo applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contributions –\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA- Hind Aljanaahi\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eB- Abrar Alsalami\u003c/p\u003e\n\u003cp\u003eC- Dr Shabnam Saquib\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1- Design of the work- C ,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e2-Analysis OR interpretation of data- A.B.C\u003c/p\u003e\n\u003cp\u003e3- The creation of new software used in the work - A.B\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;4- Drafted the work or substantively revised it - A.B.C\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement:\u003c/strong\u003e We would like to convey our genuine appreciation to Dr. Jeyaseelan Lakshmanan, Professor of Biostatistics, Mohamed Bin Rashid University of medical and health sciences ( MBRU) and Dr Marwan Zidan, Statistician, Dubai Health (DH) for statistic evaluation and guidance throughout this project.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e\u003cstrong\u003eUAE National Health Survey Report 2017\u0026ndash;2018\u003c/strong\u003e. Ministry of Health and Prevention, United Arab Emirates; 2018. Available from: https://www.mohap.gov.ae/en/MediaCenter/Publications/Documents/UAE%20National%20Health%20Survey%20Report%202017-2018.pdf\u003c/li\u003e\n\u003cli\u003eMamdouh H, Hussain HY, Ibrahim GM, Alawadi F, Hassanein M, Zarooni AA, et al. Prevalence and associated risk factors of overweight and obesity among adult population in Dubai: a population-based cross-sectional survey in Dubai, the United Arab Emirates. \u003cem\u003eBMJ Open\u003c/em\u003e. 2023;13(1):e062053. doi:10.1136/bmjopen-2022-062053 \u003c/li\u003e\n\u003cli\u003eD\u0026apos;Souza R, Horyn I, Pavalagantharajah S, Zaffar N, Jacob CE. Maternal body mass index and pregnancy outcomes: a systematic review and meta-analysis. \u003cem\u003eAm J Obstet Gynecol MFM\u003c/em\u003e. 2019;1(4):100041. doi:10.1016/j.ajogmf.2019.100041 ajogmfm.org\u003c/li\u003e\n\u003cli\u003eBegum KS, Sachchithanantham K, De Somsubhra S. Maternal obesity and pregnancy outcome. \u003cem\u003eClin Exp Obstet Gynecol\u003c/em\u003e. 2011;38(1):14\u0026ndash;20.\u003c/li\u003e\n\u003cli\u003eAl-Rifai RH, Ali N, Barigye ET, Al Haddad AHI, Al-Maskari F, Loney T, et al. Maternal and birth cohort studies in the Gulf Cooperation Council countries: a systematic review and meta-analysis. \u003cem\u003eSyst Rev\u003c/em\u003e. 2020;9(1):14. doi:10.1186/s13643-020-1277-0 BioMed Central\u003c/li\u003e\n\u003cli\u003eGupta S, Kapoor S. Independent and combined association of parity and short pregnancy with obesity and weight change among Indian women. \u003cem\u003eHealth\u003c/em\u003e. 2012;4(5):271\u0026ndash;6. doi:10.4236/health.2012.45044 PMC\u003c/li\u003e\n\u003cli\u003eKent L, McGirr M, Eastwood K-A. Global trends in prevalence of maternal overweight and obesity: A systematic review and meta-analysis of routinely collected data retrospective cohorts. \u003cem\u003eInt J Popul Data Sci\u003c/em\u003e. 2024;9(2). doi:10.23889/ijpds.v9i2.2401 PopData Science Journal\u003c/li\u003e\n\u003cli\u003eDevlieger R, Benhalima K, Damm P, Van Assche A, Mathieu C, Mahmood T, et al. Maternal obesity in Europe: where do we stand and how to move forward? A scientific paper commissioned by the European Board and College of Obstetrics and Gynaecology (EBCOG). \u003cem\u003eEur J Obstet Gynecol Reprod Biol\u003c/em\u003e. 2016;201:203\u0026ndash;8. doi:10.1016/j.ejogrb.2016.04.005 \u003c/li\u003e\n\u003cli\u003eGaltier-Dereure F, Boegner C, Bringer J. Obesity and pregnancy: complications and cost. \u003cem\u003eAm J Clin Nutr\u003c/em\u003e. 2000;71(5 Suppl):1242S\u0026ndash;8S. doi:10.1093/ajcn/71.5.1242s ResearchGate+1PubMed+1\u003c/li\u003e\n\u003cli\u003eBerger H, Melamed N, Murray-Davis B, Hasan H, Mawjee K, Barrett J, et al. Prevalence of pre-pregnancy diabetes, obesity, and hypertension in Canada. \u003cem\u003eJ Obstet Gynaecol Can\u003c/em\u003e. 2019;41(11):1579\u0026ndash;88.e2. doi:10.1016/j.jogc.2019.03.034 \u003c/li\u003e\n\u003cli\u003eSingh GK, DiBari JN, Lee H. Prevalence and social and built environmental determinants of maternal prepregnancy obesity in 68 major metropolitan cities of the United States, 2013\u0026ndash;2016. \u003cem\u003eJ Environ Public Health\u003c/em\u003e. 2021;2021:6650956. doi:10.1155/2021/6650956 Wiley Online Library\u003c/li\u003e\n\u003cli\u003eFatima T, Fatima Zahra L, Fatima B, Nadia H, Hassan A, Amina B. Study of the prevalence of obesity and its association with maternal and neonatal characteristics and morbidity profile in a population of Moroccan pregnant women. \u003cem\u003eJ Nutr Metab\u003c/em\u003e. 2021;2021:6692312. doi:10.1155/2021/6692312 \u003c/li\u003e\n\u003cli\u003eZutshi A, Santhosh J, Sheikh J, Naeem F, Al-Hamedi A, Khan S, et al. Implications of early pregnancy obesity on maternal, fetal and neonatal health: retrospective cohort study from Oman. \u003cem\u003eSultan Qaboos Univ Med J\u003c/em\u003e. 2018;18(1):e47\u0026ndash;53. doi:10.18295/squmj.2018.18.01.009 \u003c/li\u003e\n\u003cli\u003eMelchor I, Burgos J, Del Campo A, Aiartzaguena A, Guti\u0026eacute;rrez J, Melchor JC. Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study. \u003cem\u003eJ Perinat Med\u003c/em\u003e. 2019;47(6):625\u0026ndash;30. doi:10.1515/jpm-2019-0103 De Gruyter Brill\u003c/li\u003e\n\u003cli\u003eOtero-Naveiro A, G\u0026oacute;mez-Fern\u0026aacute;ndez C, \u0026Aacute;lvarez-Fern\u0026aacute;ndez R, P\u0026eacute;rez-L\u0026oacute;pez M, Paz-Fern\u0026aacute;ndez E. Maternal and fetal outcomes during pregnancy and puerperium in obese and overweight pregnant women: a cohort study. \u003cem\u003eArch Gynecol Obstet\u003c/em\u003e. 2021;304(5):1205\u0026ndash;12. doi:10.1007/s00404-021-06061-3\u003c/li\u003e\n\u003cli\u003eSimko M, Totka A, Vondrova D, Samohyl M, Jurkovicova J, Trnka M, et al. Maternal body mass index and gestational weight gain and their association with pregnancy complications and perinatal conditions. \u003cem\u003eInt J Environ Res Public Health\u003c/em\u003e. 2019;16(10):1751. doi:10.3390/ijerph16101751 \u003c/li\u003e\n\u003cli\u003eTaha Z, Hassan AA, Papandreou D. Epidemiology of pre-pregnancy body mass index (BMI) among mothers in Abu Dhabi, the United Arab Emirates. \u003cem\u003eFront Glob Womens Health\u003c/em\u003e. 2022;3:893808. doi:10.3389/fgwh.2022.893808\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 and 2 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Obesity, Gestational Hypertension, Gestational Diabetes, Preeclampsia, Primiparous, Neonatal complication","lastPublishedDoi":"10.21203/rs.3.rs-6742711/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6742711/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eMaternal Obesity has emerged as a significant global health concern. Obese women in reproductive age carries significant risk of adverse pregnancy and neonatal outcomes.\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e\u003cp\u003eThe study aim to evaluate the point prevalence of maternal obesity and its impact on pregnancy and neonatal outcomes.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis was retrospective cohort study done at Dubai and Latifa hospitals in Dubai, United Arab Emirates from 2018\u0026ndash;2022. Inclusion criteria were primiparous women, age 20-30years, singleton pregnancy with no past uterine surgeries or pre-existing medical conditions. They were divided into Non-obese (BMI\u0026thinsp;\u0026le;\u0026thinsp;30 kg/m\u0026sup2;) and Obese ((BMI\u0026thinsp;\u0026gt;\u0026thinsp;30 kg/m\u0026sup2;). Primary outcome assessed were antenatal complication (gestational hypertension, pre-eclampsia, gestational diabetes, preterm premature rupture of membranes), delivery outcome (mode of delivery and blood loss) and neonatal outcome (gestational age at delivery, Apgar score, and neonatal intensive care admission).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAmong the study population, more than half of the pregnant women (53.4%) were classified as obese with a BMI\u0026thinsp;\u0026ge;\u0026thinsp;30 kg/m\u0026sup2;. Obesity was significantly associated with adverse pregnancy outcomes, including a higher incidence of gestational hypertension(p\u0026thinsp;=\u0026thinsp;0.003), gestational diabetes(p\u0026thinsp;=\u0026thinsp;0.014), pre-eclampsia(p\u0026thinsp;=\u0026thinsp;0.022), caesarian section(p\u0026thinsp;=\u0026thinsp;0.001), preterm delivery(p\u0026thinsp;=\u0026thinsp;0.012) and neonatal intensive care unit (NICU) admissions(p\u0026thinsp;=\u0026thinsp;0.015). Furthermore, a positive correlation was observed between increasing obesity class and a higher risk of postpartum hemorrhage.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eOur study reveals that in our population 53.4% of women entered their pregnancy with obesity, demonstrating significant pregnancy and neonatal complication. These finding underscore the critical need for targeted intervention to address obesity in pregnancy protocols to optimize maternal and fetal outcomes.\u003c/p\u003e","manuscriptTitle":"Impacts of maternal obesity on pregnancy and neonatal outcome: A Retrospective cohort study (2018-2022).","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-14 10:25:44","doi":"10.21203/rs.3.rs-6742711/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5f1be014-1ec3-442d-9872-4ce7c4cfd1ca","owner":[],"postedDate":"July 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-25T14:08:54+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-14 10:25:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6742711","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6742711","identity":"rs-6742711","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}