Maternal obesity and outcome of pregnancy, are they related?

ABSTRACT

To show the increased risk of adverse outcomes in labour and fetomaternal morbidity in obese women [BMI > 30]. A population-based observational study. Primigravid women with a singleton uncomplicated pregnancy with cephalic presentation of 37 or more weeks of gestation with accurate information regarding height and weight recorded at the booking visit [measured by the midwives] were included in the study. Comparisons were made between women with a body mass index of 2030 and those with more than 30. SPSS version 10 was used for statistical analysis. Student's t test, chi[2] and Fisher's exact tests were used wherever appropriate. Labour outcomes assessed were risk of postdates, induction of labour, mode of delivery, macrosomia and shoulder dystocia. Fetal wellbeing was assessed using Apgar <7 at 5 minutes, trauma and asphyxia, cord pH < 7.2, babies requiring neonatal ward admissions, tube feeding and incubator. We report an increased risk [quoted as odds ratio [OR] and confidence intervals CI]] of postdates, 1.4 [1.21.7]; induction of labour, 1.6 [1.31.9]; caesarean section, 1.8 [1.42]; macrosomia, 2.1 [1.62.6]; shoulder dystocia, 2.9 [1.45.8]; increased neonatal admissions with complications such as neonatal trauma, feeding difficulties and incubator requirement. Obese women appear to be at risk of intrapartum and postpartum complications. Induction of labour appears to be the starting point in the cascade of events. They should be considered as high risk and counseled accordingly