Investigating the Effect of Maternal Overweight and Obesity on Birth Outcomes in Selected Tertiary Hospitals in Enugu State, South East Nigeria

Maternal overweight and obesity are increasingly recognised risk factors for adverse pregnancy outcomes including gestational diabetes, preeclampsia, caesarean delivery, and macrosomia. In South East Nigeria, the dual burden of undernutrition and overnutrition among women of reproductive age presents a complex public health scenario. This study investigated the effect of maternal overweight and obesity on birth outcomes at selected tertiary hospitals in Enugu State, South East Nigeria. A prospective cohort design was used, with 280 pregnant women enrolled at first antenatal visit and followed up to delivery. Pre-pregnancy BMI was estimated from self-reported pre-pregnancy weight and measured height at enrolment. Birth outcomes assessed included gestational age at delivery, birth weight, mode of delivery, and APGAR scores. Obstetric and neonatal data were abstracted from hospital records. Multivariate logistic and linear regression models were fitted to assess BMI-outcome associations. Results showed that overweight and obese women had significantly higher odds of caesarean section, gestational diabetes, and macrosomia. Pre-pregnancy obesity was associated with a 2.8-fold increased odds of gestational hypertension. Preterm delivery risk was elevated in obese women. Adequate antenatal weight gain modified but did not eliminate these risks. The study recommends preconception weight management programmes and routine obesity screening in antenatal care in Enugu State. Keywords: maternal obesity, birth outcomes, pregnancy, Enugu State, gestational complications