**Author details**

important predictor to assess the healthy outcome of a baby. BMI can be directly correlated to neonate obesity, preterm birth complications, shoulder dystocia, and other complications [33]. Nonetheless, BMI still is an important factor that influences the growth and development

In third world countries where maternal nutrition has a profound effect on the fetal growth and development during pregnancy, the anthropometric parameter such as intrauterine growth (IUG) chart alone is not enough to assess the level of fetal malnutrition. BMI, which is based on weight to length ratio, is further an effective and sensitive method to assess the level of malnutrition [35]. As pregnancy is an important period for the fetal growth and development, any metabolic changes like maternal weight gain due to diabetes, dyslipidemia, or weight loss due to the chronic infections and diseases can affect the fetal health and development. Fetal macrosomia, limited or stunted growth of the fetus, pre-term delivery of the offspring are often the result of maternal pre-pregnancy BMI dysregulation [36]. Hence, maternal prepregnancy BMI can be an effective tool in poor countries to anticipate and predict neonatal

Glucose being one of the major energy substrates has shown to cross the placenta via facilitated diffusion mechanism but no evidence is present to show the feto-maternal placental exchange of insulin [37–39]. In a proposed model of diabetic pregnancy of Pederson, it was presumed that excess maternal glucose could pass through the blood-placental barrier and result in stimulation of endogenous fetal insulin production in the developing fetus rather than direct feto-maternal insulin exchange [40]. There are studies supporting this model where a positive correlation between the cord C peptide along with insulin production and weight of the infant has been shown [38, 39]. This exchange of excess glucose probably can be associated with the insulin resistance of the mother and thereby link the role of maternal BMI in controlling the level of the excess glucose production and its placental exchange leading to

It can be concluded that the maternal BMI plays a profound role and can be good indicators of birth weight and development of the fetus [42]. Apart from the risk factors associated with the delivery of a preterm and overweight baby, maternal BMI can be also an important indirect predictor of mothers at risk of delivering abnormal weight babies in developing, and poor countries [43, 44]. Also, nutrition plays a major role in fetal and maternal well being [42]. Increased risk of negative pregnancy outcomes like pre-term birth, low birth weight, intrauterine growth retardation (IUGR), small for gestational age (SGA) have shown to be associated with lower maternal pre-pregnancy BMI [45–48]. However, BMI alone cannot be an important anthropometric measurement factor for understanding the growth and development of the fetus. For a more detail understanding of the intrauterine fetal growth, other important factors like maternal height, weight, metabolic rate, total body water, and fetal

up-regulation of fetal insulin secretion and production of bigger babies [41].

of the fetus on a more general basis [34].

14 Body-mass Index and Health

health complications apart from nutritional care [36].

body density should be also considered [5, 49].

**4. Conclusion**

Niranjan Bhattacharya\* and Priyodarshi Sengupta

\*Address all correspondence to: sanjuktaniranjan@gmail.com

Department of Regenerative Medicine and Translational Science, Calcutta School of Tropical Medicine, West Bengal, India
