Double Burden: Maternal Non-Communicable Diseases and Perinatal Outcomes in India

Abstract

Introduction: The increasing prevalence of NCDs such as diabetes, hypertension, and obesity among women of reproductive age can lead serious and lasting impacts on the health of both mother and child. The objective of this narrative review is to understand the association between maternal NCDs and adverse perinatal outcomes.

Methodology: PubMed, Scopus, and Google Scholar databases were searched for studies using keywords like "maternal non-communicable diseases", "perinatal outcomes", "gestational diabetes", "hypertension in pregnancy", "maternal obesity". Articles exploring the link between pre-existing or gestationally-developed NCDs and specific perinatal outcomes were selected and reviewed.

Results: Evidence shows a strong, consistent link between maternal NCDs and adverse perinatal outcomes. Hypertensive disorders complicated an estimated 7–10% of pregnancies and according to one prospective cohort study, severe pre-eclampsia was associated with a more than eightfold higher risk of perinatal death (Risk Ratio 8.60). Some Indian studies report gestational diabetes mellitus (GDM) prevalence as high as 14%; findings from a study showed GDM is a strong predictor for macrosomia and neonatal hypoglycaemia. Findings from a key Indian analysis showed that obese pregnant women had substantially higher odds of developing GDM (OR 4.85) and hypertensive disorders (OR 3.83).

Conclusion: The increasing prevalence of NCDs among pregnant women in India poses a serious threat to achieving national and global maternal and child health goals. The findings of this review show an urgent need to transition from a purely infection-focused antenatal model to an integrated one that includes routine screening, early diagnosis, and effective management of NCDs.

Keywords: Pregnancy, Gestational, Perinatal Death, Noncommunicable Diseases, Obesity.