Maternal obesity and its adverse impact on labor outcome

ABSTRACT

To study the impact of maternal obesity on the outcome of labour. Al Zahraa University hospital prospective randomized control study. A total of [80] pregnant women were included in this study from April 2009 to March 2010. According to the BMI the patients were classified into two groups. Group [I] [Control Group] Included [30] patients with [body mass index] [BMI] ranging from 20 to 25 kg/m[2].Group [II] [Obese Group] Included [50] patients with [BMI] ranging from 25 to 30kg/m[2]. Each patient were subjected to full clinical examination [General] Abdominal and pelvic] U/S pelviabdominal examination that is to confirm the inclusion and exclusion criteria of the study. A significant differences was noticed between 2 groups as regard the BMI. The current study showed significant difference in cases subjected to induction of labour with p-value < 0.001. Also significant difference between control group and obese group regarding failed induction, failure to progress 1[st] stage, 2[nd] stage, shoulder dystocia with p-value < 0.01.Case of C.S showed the highest significant diff. with P-value < 0.0001 .In the present study no sig. diff. between cases of both groups as regard 3rd stage complication, 4th stage [PPH] and blood transfusion with P-value 0.658, 0.684 and 0.658 respectively. A high significant diff. between the two groups as regard case of macrosomia, Apgar score < 7 1[st] minute, and birth injury with p-value < 0.01. A significant diff. were showed between the cases of both groups as regard the incubation with p-value > 0.05.No significant diff. were noticed between the 2 groups as regard the cases with Apgar score < 7 at 5 minutes with p-value 0.06. A positive correlation coefficient between the BMI [25-29], [29-33] kg/m[2] with the case of induction of labour, failure to progress 1[st] stage, shoulder dystoca, cesarean section and fetal low Apgar score. While a negative correlation was recorded between the BMI of the control group and all the adverse outcomes. Obesity of the gravid women is a sensitive predictor of the adverse outcome during pregnancy, labour, and post partum. Researches are needed into effective, applicable and acceptable community -based program for obese women planning a pregnancy