Faradiyan Kencana, Ani Retno Prijanti, Yuditiya Puwosunu, Wimba Widagdo Dinutanayo, Adinda Juwita Sari

Higher Risk of Preeclampsia Among Overweight and Obese Pregnant Women Compared to Normal BMI Women

Introduction

Higher risk of preeclampsia among overweight and obese pregnant women compared to normal bmi women . Explore the link between BMI and preeclampsia. Overweight and obese pregnant women face a significantly higher risk of this serious pregnancy complication. Maintaining a healthy BMI is crucial.

Abstract

Preeclampsia is a pregnancy complication characterized by hypertension and proteinuria, affecting 2–8% of pregnancies worldwide, with a prevalence of 24% in Indonesia. Its etiology remains unclear due to its complex, multifactorial nature, and several factors, such as age, obesity, pre-existing conditions, and multiple pregnancies, may influence its occurrence. This study aims to investigate the relationship between body mass index (BMI) and preeclampsia in pregnant women. An analytical observational study was conducted using purposive sampling, involving 18 participants in each group. Secondary data were obtained from medical records at Rumah Sakit Cipto Mangunkusumo, Rumah Sakit Budi Kemuliaan, and Puskesmas Senen. Statistical analysis was performed using the Chi-square test. Results show that 17 respondents (47.2%) with overweight or obesity had preeclampsia, whereas 8 respondents (22.2%) with normal BMI did not. The Chi-square test indicated a significant association between BMI and preeclampsia (p=0.007). Higher BMI is significantly associated with preeclampsia. Maintaining a healthy BMI during pregnancy may reduce the risk of this condition.

Review

This analytical observational study addresses a highly relevant clinical issue, investigating the association between maternal Body Mass Index (BMI) and the risk of preeclampsia, a significant pregnancy complication with a notable prevalence in Indonesia. The authors clearly state their objective to examine this relationship. Utilizing medical record data from specific institutions and employing a Chi-square test, the study identifies a statistically significant association (p=0.007), concluding that overweight and obese pregnant women face a higher risk of developing preeclampsia. Specifically, the findings indicate a high prevalence of preeclampsia in the overweight/obese group (17 out of 18 participants) compared to the normal BMI group (10 out of 18 participants), reinforcing the widely recognized link between higher BMI and adverse pregnancy outcomes. While the study's objective is clear and the chosen statistical method is appropriate for categorical data, several methodological limitations significantly constrain the interpretation and generalizability of its findings. The most prominent weakness is the extremely small sample size, involving only 36 participants in total (18 per group). Such a limited sample size raises serious concerns about statistical power, the representativeness of the sample, and the robustness of the reported p-value. Furthermore, the use of purposive sampling introduces potential selection bias, and the reliance on secondary data from medical records may lead to inconsistencies or missing information crucial for comprehensive analysis. Critically, despite acknowledging the multifactorial nature of preeclampsia and listing several influential factors (age, pre-existing conditions, multiple pregnancies), the abstract does not indicate whether these potential confounders were accounted for in the analysis, which is essential for establishing a reliable association in an observational study. Despite these limitations, the study contributes to the local evidence base by reinforcing the known association between elevated BMI and preeclampsia within an Indonesian context. The reported high prevalence of preeclampsia in both BMI groups within this specific cohort warrants further investigation. For future research, it is strongly recommended that studies employ significantly larger sample sizes, preferably through multi-center or prospective cohort designs, to enhance statistical power and generalizability. Rigorous control for confounding variables is also imperative to isolate the independent effect of BMI. Ultimately, while this study highlights the continued importance of healthy BMI management in pregnancy, its conclusions should be interpreted with caution given the methodological constraints, serving primarily as a preliminary exploration that necessitates more robust and comprehensive follow-up research.

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