Impact of Maternal Obesity on Early Neonatal Outcomes

Objective: To evaluate the impact of maternal obesity on maternal, perinatal, and early neonatal outcomes.Methods: This retrospective cohort was conducted in a tertiary care university hospital between 2017 and 2021 in Istanbul. Women with a first-trimester body mass index (BMI) of >30.0 kg/m² were included in the maternal obesity group, and their maternal, perinatal clinical characteristics, and neonatal outcomes at the early postnatal period were compared with the age- and neonatal sex-matched non-obese control group (BMI <30.0 kg/m²).Results: The study included 1252 mother–infant dyads, with 626 infants in each group. In terms of pregnancy complications, maternal obesity was significantly associated with higher rates of both pregestational and gestational hypertension and diabetes mellitus (all p<0.001), and increased cesarean delivery rates (p<0.001). Infants born to obese mothers had significantly higher birth weight and higher rates of being large for gestational age (LGA) (p<0.001). These infants also demonstrated higher neonatal intensive care unit admission rates (p<0.001) compared with infants born to non-obese mothers. Early neonatal metabolic complications, including early formula supplementation (p<0.001), hypoglycemia (p = 0.02), and hypernatremia (p = 0.005), were significantly more frequent in the maternal obesity group.Conclusions: Maternal obesity is associated with adverse maternal, perinatal, and early neonatal outcomes, including delivery mode, postnatal neonatal metabolic adaptation, and early feeding difficulties. Early identification of high-risk pregnancies, individualized antenatal care, and structured postnatal feeding support may help reduce preventable maternal and neonatal complications.