Pregnancy Outcome Among Obese Women: A Prospective Study

Abstract

We investigated pregnancy outcome among obese women using a prospective cohort study comparing consecutive deliveries of obese and nonobese patients. Stratified analysis, using the Mantel-Haenszel technique, was done to assess the association between obesity and the risk for cesarean delivery (CD) while controlling for confounding variables. Complete data were abstracted for 376 women, of whom 21% ( N = 79) were obese. CD rate was significantly higher among obese women (32.9% versus 18.9%; P = 0.006). Maternal obesity was associated with multiparity (odds ratio [OR] 2.97, 95% confidence interval [CI] 1.27 to 6.97; P = 0.012), fertility treatments (OR 11.3, 95% CI 2.84 to 44.89; P = 0.001), insulin-treated gestational diabetes (OR 24.55, 95% CI 2.28 to 264.08; P = 0.008), and hydramnios (OR 20.46, 95% CI 2.17 to 192.89; P = 0.008). When controlling for possible confounders, the association between maternal obesity and CD remained significant (weighted OR 2.2, 95% CI 1.2 to 4.1; P = 0.018). No significant differences were noted between the groups regarding neonatal complications. Both first and second stages of labor were longer in obese women. Obesity is a risk factor for developing gestational hypertension, insulin-treated gestational diabetes, and hydramnios. Moreover, maternal obesity is an independent risk factor for CD. Additional independent risk factors for CD were fertility treatments, insulin-treated gestational diabetes, and hydramnios. However, neonatal outcome of obese women is comparable to women with normal prepregnancy body mass index.

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.…”

Early Intensive Obstetric and Medical Nutrition Care Is Associated with Decreased Prepregnancy Obesity Impact on Perinatal Outcomes

“…We did not find an increased frequency in other previously reported adverse outcomes in OB and OW women [3,4,5,6,7,23,24,25]. …”

“…In the last two decades in México there has been a rapidly progressive increase in the incidence of women with overweight and obesity [2], a well-recognized risk factor for increased maternal, fetal and neonatal adverse outcomes [3,4,5,6,7,15,16,17]. Thus, it is important to search for alternative medical-nutrition approaches in the management of this obstetric population aimed to decrease these body weight-related morbidities, one of the few amendable risk factors before and during pregnancy.…”

“…Some studies have analyzed the independent effects of obesity on pregnancy outcomes in glucose-tolerant Caucasian women [3,5,6], but few in Hispanic women who have a greater risk for GDM [8,9] among other morbidities.…”

“…Cesarean delivery, gestational diabetes mellitus (GDM), hypertensive disorders including preeclampsia, abortions, premature rupture of membranes, stillbirth, early neonatal death, macrosomia and major congenital malformations [3,4,5,6,7]. …”