Maternal Obesity and Its Associated Factors and Outcomes in Klang Valley, Malaysia: Findings from National Obstetric Registry

Nurul Farehah Shahrir; Rohana Abdul Jalil; J Ravichandran R Jeganathan; Shamala Devi Karalasingam; Noraihan Mohd Nordin; Mohamad Farouk Abdullah; Nadiah Sa'at

doi:10.51866/oa1138

Maternal Obesity and Its Associated Factors and Outcomes in Klang Valley, Malaysia: Findings from National Obstetric Registry

Malays Fam Physician. 2021 Sep 24;16(3):56-67. doi: 10.51866/oa1138. eCollection 2021 Nov 30.

Authors

Nurul Farehah Shahrir¹, Rohana Abdul Jalil², J Ravichandran R Jeganathan³, Shamala Devi Karalasingam⁴, Noraihan Mohd Nordin⁵, Mohamad Farouk Abdullah⁶, Nadiah Sa'at⁷

Affiliations

¹ Candidate Doctor of Public Health, MBBS (UiTM), MPH (USM), Department of Community Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan Malaysia.
² MSc, Ph.D (Community Nutrition) (USM), Department of Community Medicine Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan Malaysia, Email: rohanajalil@usm.my.
³ MD (USM), MMed Obstetrics and Gynecology (USM), Department of Obstetrics & Gynaecology, Hospital Sultanah Aminah, Johor Bahru, Ministry of Health, Malaysia.
⁴ MD(Mangalore University), MMed Obstetrics and Gynaecology (University Malaya), National Obstetrics Registry, Institute Clinical Research, National Institute of Health, Ministry of Health, Malaysia.
⁵ FRCOG (Lon), MMedSci in ART U of Notts UK, Department of Obstetrics and Gynaecology, Tunku Azizah Hospital Women and Children Hospital, Kuala Lumpur, Ministry of Health, Malaysia.
⁶ MBBS (Malaya), FRCOG (London) Perdana University, Graduate School of Medicine, Perdana University Kuala Lumpur, Malaysia.
⁷ Bac Sc Mathematics (UPM), Centre for Coordination of Clinical Research Network, Institute Clinical Research, National Institute of Heath Ministry of Health, Malaysia.

PMID: 34938393
PMCID: PMC8680946
DOI: 10.51866/oa1138

Abstract

Introduction: Maternal obesity presents significant health risks to mothers and their fetuses. This study aimed to determine the proportion, associated factors and outcomes of maternal obesity among pregnant women in Klang Valley, Malaysia.

Methods: A retrospective cross-sectional study was conducted between January 2018 and March 2018 using secondary data from the Malaysian National Obstetric Registry (NOR) for the year 2015. All pregnant women with first-trimester booking at 12 weeks and below that were registered with the NOR and met the inclusion and exclusion criteria were included in the study. Descriptive statistics and multiple logistic regression analysis were used. Data were analysed using SPSS version 22.0. A total of 2113 respondents were included in this study to determine the proportion, associated factors and outcomes of maternal obesity. Regarding the univariate and multivariate analyses, respondents were classified into two groups: normal and obese. The obese group comprised overweight and obese mothers. The underweight group was excluded in the subsequent analysis.

Results: Out of the 2113 respondents, 7.1% were underweight, 41.7% were of normal weight, 28.6% were overweight, 15.9% were in obese class I, 4.6% were in obese class II, and 2.1% were in obese class III according to the WHO (1995) reference. However, when the MOH (2003) cutoff point was used, there was a marked increase in the proportion of respondents in the overweight categories by 2.7% and obesity class I by 12.8%. The Indian (AdjOR 2.06, 95% CI: 1.11, 3.83, p=0.021) and Malay (AdjOR 1.75, 95% CI: 1.02, 3.00, p=0.040) ethnicities, as well as both multiparity (AdjOR 1.46, 95% CI: 1.23, 1.73, p <0.001) and grand multiparity (AdjOR 2.41, 95% CI: 1.78, 3.26, p <0.001), were significantly associated with maternal obesity. There were significant association between maternal obesity with hypertensive disorder in pregnancy (p=0.025), caesarean section delivery (p=0.002) and macrosomic infant (p <0.001).

Conclusion: The identification of risk factors for maternal obesity is important to facilitate intervention programmes focused on improving the pregnancy outcomes for a high-risk group of women.

Keywords: Maternal obesity; associated factors; ethnicity; national obstetric registry.