ASSESSMENT OF MATERNAL ABDOMINAL SUBCUTANEOUS FAT THICKNESS (SFT) AS AN
INDEPENDENT PREDICTOR OF ADVERSE PREGNANCY OUTCOMES: A PROSPECTIVE
COHORT STUDY
Abstract
Introduction: Obese pregnant women are at increased risk for a
variety of maternal and perinatal complications. The maternal risks
related to obesity include Gestational Diabetes mellitus, Preeclampsia,
increased caesarian sections. The fetus is at risk of stillbirth,
preterm birth and congenital anomalies.This study focuses on the use of
Maternal abdominal subcutaneous fat thickness (SFT) as a surrogate
measure for central obesity as measured by ultrasound, and determining
its efficacy compared to BMI in predicting obesity related pregnancy
complications. Objective: To measure mid-trimester SFT in
antenatal women and establish SFT as an independent predictor of obesity
related adverse pregnancy outcomes Methods: This was a
prospective cohort study. 150 pregnant women between 20-40 years of age
were recruited. Demographic data of each participant was collected from
the OPD. USG for abdominal subcutaneous fat thickness (SFT) was done at
18-22 wks period of gestation.The participants were followed up to
labour. Adverse pregnancy outcomes and their correlation with the SFT
measured was studied. Results: There was significant positive
correlation between BMI and SFT (r=0.591, p<0.001) .A positive
correlation was noticed between BMI and adverse pregnancy outcomes such
as PIH, GDM , preterm birth , postdatism and NICU admissions.SFT
independently showed a positive correlation with the above parameters.
The mean SFT among women without PIH was 11.45 mm, and with PIH was
16.48 mm[p <0.001].Mean SFT were 11.68mm and 16.24 mm
among the ladies without and with GDM
respectively[p<0.001]. The mean SFT for term pregnancies
was 12.06 mm whereas the mean SFT for preterm births was 14.21 showing
positive correlation between SFT and preterm birth. SFT also showed
positive correlation with need for NICU admission for neonates [ SFT
avg being 11.72mm and 14.94 mm in the 2 groups]. A comparative
analysis was done between BMI and SFT regarding their correlation to the
various outcomes. SFT showed higher correlation coefficients for these
variables than BMI, with lower p values suggesting more statistical
significance. Conclusion: BMI showed a positive correlation
with adverse pregnancy outcomes in mother as well as fetus, SFT showed
greater and more statistically significant correlation for adverse
outcomes. Thus it was concluded that SFT is a better independent
predictor of obesity related adverse pregnancy outcomes.