Endocrine Abstracts

Introduction: Obesity is a public health problem that also affects pregnant and breastfeeding women. Pre-gestational obesity is deleterious and can lead to several maternal and fetal complications, as well as a delay in the initiation of breastfeeding. The objective of this work is to evaluate the impact of maternal obesity on pregnancy, labor and the quality of breastfeeding.

Material and method: Prospective case-control study conducted at the endocrinology department of the UHC Ibn Rochd Casablanca. The study group included 50 obese parturients, and the control group 50 non-obese parturients. All our patients were followed for a diabetic pregnancy.

Results: The average age of our patients was 31 years (22-42), the average gestational age 27 SA (10-36). The average BMI was 36.2 kg/m^², with an average pre-gestational BMI of 33.5 kg/m^². The average weight gain during pregnancy was 15.3 kg. Gestational diabetes predominated at 58%, with 38% of DT2 and 4% of DT1. In the study group, gestational diabetes was diagnosed at the first trimester in 36% of patients. In the obese group, a higher rate of HTAG (42%; P=0.004), pre-eclampsia (12%; P= 0.004), threats of premature delivery (14%, P=0.005) were observed., miscarriages and fetal deaths in utero (8%, P=0.03). Labor was obstructed in 12% of parturients (P=0.001), with a postpartum haemorrhage rate of 4% (P=0.05). A macrosomia rate of 24% was objectified in the obese group. Breastfeeding was initiated immediately postpartum in 72% of parturients, with an interruption of breastfeeding at 6 months in 44%. OGTT returned in favor of T2DM in 41.3% of patients whose diabetes was discovered during pregnancy.

Conclusion: Pre-gestational maternal obesity, as well as excessive weight gain during pregnancy, condition the course and outcome of pregnancy, with a higher rate of maternal-fetal complications, the risk of developing type 2 diabetes, as well as early termination of breastfeeding. Hence the importance of making obese patients aware of pre-gestational weight loss, with regular weight monitoring during pregnancy, in order to limit weight gain.