Obstetric hazards of maternal obesity

S Paiva; L Ruas; M Campos; M Melo; J Guimarães; A Lobo; E Sobral; E Marta; A Cravo; M Carvalheiro

Introduction and objective: Prevalence of obesity is increasing in fertile women. We aimed to investigate its relation with pregnancy outcome.

Methods: A retrospective analysis of 37 obese pregnant women (O group) was undertaken in the Endocrinology/Obstetric Unit, from 1998 to 2004. Control group included 33 pregnant women (C group) with normal body mass index (BMI).

Results: Our O and C groups were age matched (O: 27.9±4.35; C: 28.6±5.36 years; ns), average BMI of 38.38 (O group) and 22.5 (C group, P<0.0001). Weight gain during pregnancy was significantly more pronounced in the C group (11.82) – O group (7.89, P<0.01). Obstetric history revealed an incidence of 24.3% of spontaneous abortions in obese patients – 6% in the control group. Complications during pregnancy, women in the O group had higher incidence of GDM (16.2%) than in the C group (3%, P=0.066). Furthermore, 27% developed hypertension – C group (3%, P<0.005). There was a case of repeated urinary infection in the O group.

Delivery occurred at 39.03 weeks in the O group; 38.55 in the C group; 27% of caesarean section in the former group as compared to 12.12% in the later. Birth weight was significantly higher in the O group (3359 g vs 3096 g, P<0.01). Congenital malformations occurred in 13.5% (5) in the O group compared to 3% (1) in the C group. There wasn’t any foetal death.

A significant correlation was found between increased BMI, hypertension (P=0.009, Man-Whitney test) and GDM (P=0.012). No significant correlation between type of delivery and BMI.

Conclusions: Obesity is associated with a higher incidence of maternal and foetal morbidity, diabetes. This implies that obese women require information regarding potential hazards and advice concerning pregnancy planning.

Endocrine Abstracts

P703