Maternal obesity, neonatal complications, and childhood wheezing in Dar es Salaam, Tanzania: a multicenter study

To determine the impact of maternal pre-pregnancy obesity (PPO) and excessive gestational weight gain (EGWG) during pregnancy on risk of asthma in offspring by assessing its association with childhood wheezing illness and early neonatal complications at four referral centers in Dar es Salaam, Tanzania. This was a multicenter cross-sectional study with retrospective elements conducted among parturient and their newborns. Data collection was conducted from September 2025 to January 2026. Participants were categorized into four groups: normal pre-pregnancy weight (NPPW) with normal weight gain (NWG), NPPW with EGWG, PPO with NWG and PPO with EGWG. Phase I included 1,902 neonates and assessed early neonatal complications, while Phase II included 293 children under six years and assessed wheezing illness. In phase I, the complications that were more common in neonates born to mothers with PPO and EGWG during pregnancy were: need for resuscitation immediately after birth, meconium aspiration syndrome, moderate respiratory distress syndrome, transient tachypnea of the newborn, birth asphyxia, need for respiratory support after admission, small for gestational age/ intra uterine growth restriction, macrosomia/large for gestation age and prematurity. These associations remained significant even after controlling for confounders. In phase II, even though wheezing, asthma, hospitalization and asthma medication were more frequent among children born to mothers with pre-pregnancy obesity and excessive weight gain during pregnancy, statistical significance was not achieved. These findings underscore the critical role of maternal metabolic health in shaping neonatal outcomes, though the childhood respiratory outcomes were inconclusive in this study.