Outcome of pregnancy in a woman with an increased body mass index

Abstract

Objective To show the increased risk of adverse outcomes in labour and fetomaternal morbidity in obese women (BMI > 30). Design A population-based observational study.Setting University Hospital of Wales. The study sample was drawn from the Cardiff Births Survey, a population-based database comprising of a total of 60,167 deliveries in the South Glamorgan area between 1990 and 1999. Population 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. Methods Comparisons were made between women with a body mass index of 20-30 and those with more than 30. SPSS version 10 was used for statistical analysis. Student's t test, m 2 and Fisher's exact tests were used wherever appropriate. Main outcome measures Labour outcomes assessed were risk of postdates, induction of labour, mode of delivery, failed instrumental delivery, macrosomia and shoulder dystocia. Maternal adverse outcomes assessed were postpartum haemorrhage, blood transfusion, uterine and wound infection, urinary tract infection, evacuation of uterus, thromboembolism and third-or fourth-degree perineal tears. 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.

The effect of maternal pregnancy body mass index as a measure of pregnancy weight gain on neonatal birth weight in Maiduguri metropolitan council of Borno state, Nigeria

“…Maternal pregnancy BMI did not significantly contribute to the birth weight of neonates in current study. Similar observation was made by researchers elsewhere (UshaKiran et al, 2005). Many colleagues have also argued that neonatal birth weight is favored greatly to a point of having macrosomic neonates in obese mothers mostly (Brennand et al, 2005).…”

Can Waist Circumference Be Used as an Anthropometric Parameter to Assess the Obesity Related Pregnancy Outcome: A Case Control Study

“…The present study observed that the rate of caesarean delivery was more in the women with waist circumference ≥ 80 cm and this was found in concordance with that of Verma and Shrimaili, 3 Addo VN 17 , Burstein et al [20] (32.9% in obese, 9% in non-obese), Usha Kiran et al [16] (27% of obese women, 18% of non-obese women). Out of the vaginal births, 4.7% in group I and 11.5% in group II required instrumentation with either forceps or vacuum in the present study and was statistically insignificant.…”

“…Usha Kiran et al [16] reported <7 APGAR score at 5 min in 0.9% neonates of non-obese women and in 1.2% neonates of obese women. Bhattacharya et al [11] also reported higher stillbirth rates in the obese (1.9%) as compared to normal BMI categories (0.9%).…”

“…Wendland et al [13] in their study identified macrosomia in 9%, 11.4% and 17.1% in women having 83 cm, 88 cm and 112 cm waist circumference quintiles. A study conducted by Usha Kiran et al [16] comparing obese and non-obese based on BMI reported macrosomia in 14.8% of obese and 7.6% of non-obese women. Out of the 6 macrosomic neonates in group II, 3 were associated with gestational diabetes mellitus and the rest 3 were seen in women with very high waist circumference (>88 cm).…”

“…It was observed that the excessive blood loss in group II women was associated not only with caesarean delivery but also with vaginal delivery. Usha Kiran et al [16] on comparing non-obese and obese, based on BMI, reported increased risk of shoulder dystocia (0.5% in non-obese vs. 1.5% in obese), third and fourth degree perineal tear (0.7% on non-obese vs. 0.8% in obese), post partum hemorrhage (15.5% in non-obese vs. 22% in obese) and wound infection (1.7% in non-obese vs. 1.6% in obese) in obese women. Sebire et al [7] also reported an increased risk of postpartum hemorrhage in obese women.…”