ArticleBMC public health2026
Pre-pregnancy BMI and gestational weight gain: determinants of birthweight of term neonates in central Sri Lanka, a low-middle-income country.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPre-pregnancy body mass index (BMI) is increasing across South Asia, yet maternal underweight also remains a persistent public health concern. Low birthweight (LBW) of newborns too remains a challenge amidst high maternal BMI. Understanding the impact of maternal BMI and gestational weight gain (GWG) on offspring weight is clinically relevant in the setting of double burden of malnutrition, which is underexplored in low-income populations, creating a research gap.
methodsThis prospective cohort study was conducted at Teaching Hospital Peradeniya, Sri Lanka on 1537 pregnant women and their term newborns, to evaluate the association of maternal BMI and GWG with newborn weight across different maternal BMI categories. Pregnant women were recruited by convenient sampling technique from August 2021 to September 2023 and followed up through pregnancy. Newborns were measured at birth. Statistical analysis was performed with SPSS version 27 using Multiple Linear Regression, Spearman Correlation, and Binary Logistic Regression.
resultsPre-pregnancy BMI was higher in, 54.8% and lower in 13.8% of women, respectively. GWG in 55.4% was below the Institute of Medicine recommendation while it was higher in 11.2%. Of the newborns, 14.8% had LBW and 6.12% had high birthweight (HBW). Odds were significantly higher for a high BMI woman to have a HBW neonate (aOR = 2.147; 95% CI: 1.127-4.091, p < 0.05) and an underweight woman to have a LBW neonate (aOR = 1.989 95% CI: 1.184-3.340, p < 0.05) compared to a normal BMI woman. The odds were significantly higher to have LBW newborns to women with inadequate GWG, compared to women with normal GWG (aOR = 1.568, 95% CI: 1.054-2.333, p < 0.05). Both maternal pre-pregnancy BMI (β = 17.44,95% CI: 11.621-23.259) and GWG (β = 14.424, 95% CI: 9.986-18.861) significantly predicted newborn birthweight (p < 0.05).
conclusionPre-pregnancy BMI and GWG positively predicted newborn birthweight. Both high and low pre-pregnancy BMI are associated with HBW and LBW, respectively and inadequate GWG is associated with LBW newborns. Strategic planning to achieve healthy pre-pregnancy BMI among women of childbearing age and to optimize GWG across all maternal BMI categories are recommended as priorities in delivering maternal and child healthcare.
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