Publication:

Maternal body mass index in outcome of pregnancy

Background The increasing prevalence of obesity in young women is a major public health concern. These trends have a major impact on pregnancy outcomes in these women, which have been documented by several researchers. The objective of this study was to assess antenatal, intra-partum complications, perinatal outcome in pregnant women with high BMI.

Methods A total number of 100 cases were included in the study out of which, 50 cases were pregnant women with high BMI (> or = 30 kg/m2), 50 were pregnant women with normal BMI (20-24 kg/m2). Their pregnancy outcome were observed and compared. The outcome variables evaluated in study were rates of preeclampsia, gestational diabetes, cesarean delivery, failed induction, operative vaginal deliveries, birth weight, and postpartum infection.

Results Most of the patients that is, 60% of obese group and 68% of control group were between 20-25years, 28% of obese group and 8% of control group were between 31-35years. In our study most of the patients, 66% of obese group and 56% of control group were primiparas, whereas 34% of obese and 44% of normal group were multipara. There is a fourfold increase in the incidence of pre-eclampsia in the obese group compared to normal BMI group. Incidence of gestational diabetes is 2% in normal group compared to 8% in obese group that is fourfold increase in incidence in obese group. Pre-term labor is 8% among obese and 2% among control groups, a significant increase. Incidence of induction of labor is doubled in obese group, incidence being 20% in control group and 40% in obese group. Incidence of instrumental delivery is 14% in obese group and 6% in control group. 32% of obese group underwent cesarean section when compared to 12% of control group. The incidence of cesarean section is 3times higher in obese group. Macrosomia is the most common complication observed in the study, the incidence being 22% in obese group and 2% in control group. There is increase in incidence by eleven fold. Incidence of low APGAR score is increased by twofold.

Conclusions Maternal BMI shows strong associations with pregnancy complications and outcome. Both maternal and fetal complications are increased.