Due to a shift in diet and sedentary lifestyles, populations are experiencing a boom in obesity, particularly in low- and middle-income families. Researchers have found that maternal obesity is now a problem in sub-Saharan Africa, where early neonatal death is more common among babies born to this population of women.
Cross-sectional demographics and health surveys from 27 sub-Saharan countries (2003-2009) were collected by Jenny A. Cresswell, MSc, PhD, and colleagues from the department of epidemiology and population health at London School of Hygiene and Tropical Medicine in London.
“Neonates born to obese mothers are at increased risk of complications including admission to neonatal intensive care, macrosomia, low Apgar scores, and perinatal death. We know of no previous studies that have investigated the effect of maternal obesity on neonatal mortality in low-income countries, where the burden of neonatal mortality is greatest,” the researchers wrote.
Cresswell and colleagues used multivariable logistic regression analysis to investigate the risk for neonatal death, among the most recent live births within 5 years before the survey, by maternal BMI category, which was measured during the survey. The timing of neonatal death was examined through a discrete-time survival model.
Of the 81,126 women eligible for the study, 15,518 were overweight and 4,266 were obese, according to data. Additionally, 52,006 had a favorable BMI and 13,602 were underweight. There were 1,290 neonatal deaths in the patient population, which related to a neonatal mortality rate of 16 per 1,000 live births, researchers wrote.
After adjustments for confounding factors, maternal obesity was linked to increased odds for neonatal death (OR=1.46; 95% CI, 1.11-1.91). Moreover, researchers wrote that maternal obesity was a significant risk factor for neonatal deaths that occurred during the first 2 days of life (OR=1.62; 95% CI, 1.11-2.37). However, further data presented no statistically significant link later in the neonatal period.
“Although this study has presented the most detailed analysis of the relation between maternal BMI and neonatal mortality in low-income settings so far, it was constrained by the availability of variables,” the researchers wrote.
Further research is warranted in the form of longitudinal studies to establish a causal relationship between maternal obesity and neonatal deaths, Cresswell and colleagues wrote.
“If the association is confirmed, public health implications are that obese women should be strongly advised to deliver in a health facility capable of providing prompt emergency obstetric and neonatal care,” they wrote.
In an accompany editorial, Ellen A. Nohr, PhD, from the department of public health, section of epidemiology at Aarhus University in Denmark, said the findings force clinicians, “to see the global health burden of obesity on reproductive health in a new perspective,” but further analysis is needed. However, Nohr said the world cannot wait for “better data.”
“The findings from sub-Saharan Africa are in accordance with previous studies on maternal obesity and neonatal survival from high-income countries, which is reassuring in a scientific sense, but also alarming,” Nohr wrote. “…if we are to reduce obesity in these women, we need to develop effective interventions based on evidence from sub-Saharan Africa.”
Disclosure: The researchers report no relevant financial disclosures.