Obesity Linked to Higher Risk of Stillbirth: Insights from the Tanzania Demographic and Health Survey

Background: Obesity among women of reproductive age is an escalating public health concern. This study aimed to assess the link between body mass index (BMI) and the risk of stillbirth among women of reproductive age in Tanzania. Method: The study utilized the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey data, encompassing a weighted sample of 2,218 women of reproductive age. Bivariate and multivariable binary logistic regression analyses were employed to determine the association between maternal BMI and stillbirth. Results: The mean age of the participants was 32.7 years (SD = 8.7). Of the 2,218 women aged 15-49 years, 120 (5.4%) had ever experienced at least one stillbirth. The prevalence of overweight and obesity was 22.6% and 14.3%, respectively. The risk of stillbirth increased with higher BMI categories: 4.2% among women with BMI <25 kg/m ² , 6.2% among those with BMI 25─29.0 kg/m ² , and 9.8% among those with BMI ≥30 kg/m ² . The differences in the prevalence of stillbirth across these BMI categories were statistically significant (p < 0.001). After controlling for confounders, women with obesity had more than twice the risk of stillbirth compared to those with normal weight (aOR=2.22, 95% CI: 1.32–3.72). Conclusion: This study found that over one-third of women of reproductive age in Tanzania were either overweight or obese. It also found that an increase in maternal BMI was associated with a higher risk of stillbirths. We therefore recommend weight management strategies both before and during pregnancy to reduce the risk of adverse pregnancy outcomes.