الفهرس 
Maternal ObesityOnly 14 pages are availabe for public view
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Abstract
Obesity is characterized by excessive accumulation of fat & adipose tissue and defined as body mass index (BMI) of 30 or more (World Health Organization (WHO, 2019). BMI is calculated by dividing body weight (kg) over height squared (m2). Obesity is described as a major public health challenge of the 21st century across the globe (According to the WHO report (2020), adult obesity ranges from below 5% in China, Japan and some African countries to over 75% in urban Samoa. However, even in countries with a low prevalence of obesity such as China, there is a wide variation in the extent of the problem, reaching 20% in some cities. In the UK, 23% of the population are obese and it is predicted that more than half of the adult population will be obese by 2050 (McPherson et al, 2007). It is also a growing problem for women of reproductive age and about one fifth of pregnant women are obese in the UK.
In recent years, maternal prepregnancy body mass index (BMI) has increased, reflecting the overall increase in the prevalence of obesity (Ratnasiri et al., 2019).
High prepregnancy BMI and/ or excessive gestational weight gain (GWG) have negative implications on pregnancy outcomes and this amplifies the burden of chronic diseases putting health of both mother and infant at risk (Pongcharoen et al., 2016) Recent studies have reported that prepregnancy BMI is associated with birth weight of the infant (Yang et al., 2015)
Women who are obese are at high risk of developing preeclampsia and gestational diabetes mellitus. This in turn is found to influence the neonatal outcomes such as perinatal mortality, macrosomia, and congenital anomalies (Karasneh et al., 2021)
In addition, maternal obesity leads to higher cesarean sections and increased risk of anesthesia (Godfrey et al., 2017)
The Institute of Medicine (IOM), USA, published revised gestational weight gain (GWG) guidelines that are based on prepregnancy ranges for underweight, normal weight and obese women. These recommendations were, however, based on American women and therefore its generalizability to other populations is unclear as maternal anthropometry varies across different populations (Rasmussen et al., 2009).
We, therefore, aimed to compare the weight gain during pregnancy (using IOM weight gain guidelines) among Egyptian women across different BMI categories and to compare the pregnancy outcomes in each of the different BMI category.
Maternal obesity during pregnancy is now a public health burden that may be the culprit underlying the ever-increasing rates of adult obesity worldwide. Understanding the association between maternal obesity and adult offspring’s obesity would inform policy and practice regarding offspring health through available resources and interventions. Maternal obesity can program offspring development in an adverse way. Maternal resveratrol could be considered as a potential regimen in reprogramming adverse outcomes in the context of maternal obesity (Hsu et al., 2020).
Apart from obstetric complication, during pregnancy obesity has many other effects during child bearing ages’ for example’ obesity has a negative impact on fertility, this is because fat stores change level of sex hormone in obese women
Obesity in pregnancy has considerable implication for health service provision. A qualitative study of 16 maternity units in the north east of England confirmed that there was an increased health burden on maternity service providers (Heslehurs et al, 2007).
The adverse outcomes of pregnancy seem to be exacerbated by excessive weight gain during pregnancy. This is particularly pronounced in the women who were obese before conception (Guelinckx et al, 2008). In literature review showed a positive linear trend between CS and maternal pre-pregnancy BMI, which amplified in magnitude when combined with excessive weight gain during pregnancy. They included six studies to compare the CS rates in the group of women defined as obese in comparison with women who were considered to be of normal weight.
Association in 54,000 births from 1998 to 2001 compared with normal weight women, the fetal death rate among obese women increased with gestational age. The hazard ratio was 2.1 at 28 to 36 weeks, and 3.5 at 37 to 39 weeks, and 4.6 at 40 weeks or more weeks, the still birth was 240 percent greater in obese compared with normal weight women ( Nohr EA, et,.al 2005).
Aim of the Work
The aim of the study is to compare the weight gain during pregnancy among pregnant women across different body mass indices (BMI) categories and to compare pregnancy outcomes in each of the different BMI categories.