Is maternal body mass index associated with neonatal mortality? A pooled analysis of nationally representative data from nine Asian countries.

OBJECTIVE: Children born to mothers with abnormal body mass index (BMI) have increased risk for mortality. The aim of this study was to investigate whether maternal BMI is a risk factor for neonatal death in select Asian countries, including the nature of association between maternal BMI and the discrete timing of neonatal death.

METHODS: Nationally representative, the standard Demographic and Health Survey data from nine Asian countries were used. In all, 55 629 mothers reported their index birth; 840 reported neonatal mortality. Descriptive statistics and multivariate logistic regression analyses were applied to attain the study objective.

RESULTS: Overweight mothers had higher odds of neonatal mortality than mothers with optimum weight. No significant association was registered for obese mothers, possibly due to insufficient power. During the first 7 d (0-1 and 2-6 d) of birth, children born to overweight mothers had higher odds of dying, whereas for the remaining period (7-27 d), maternal underweight was the risk factor for neonatal mortality.

CONCLUSION: Interventions should target high-risk pregnancies to reduce the rate of neonatal mortality. With the help of community health workers or physicians, preconception counseling of prospective mothers with abnormal BMI should be devised. If conceived, underweight or overweight or obese women should be marked as high-risk pregnancy during their antenatal care visits, and they must be encouraged for delivery at an institution equipped with an emergency obstetric and neonatal care unit.