Maternal Obesity: A Global Health Problem and It's Implications on Maternal and Fetal Health
,
Abstract
Objective: To compare maternal complications and labor outcome in obese and non-obese women.
Materials and methods: It is a retrospective comparative study conducted at the Department of obstetrics and gynecology, Unit 1, Civil Hospital, Karachi from December 2008 to December 2009. A sample size of 220 gravid women is selected by Non Probability Convenience sampling technique. In these 110 obese women as cases was compared with 110 non-obese women as controls, booked at <20 weeks of gestation. Data were collected regarding maternal complication, mode of delivery and neonatal outcome by trained medical officers. Data were entered and analyzed by SPSS version 11.0 through descriptive analysis, chi-square test and independent sample t test. The p-value of <0.05 was considered significant.
Results: Pregnancy induced hypertension was present in 9 (8.2%) women in control group and 21 (19.1%) in cases (p=0.01). Gestational diabetes was seen in one (0.9%) in control compared to 8 (7.3%) in obese women (p=0.01). Obese women were found to be at increased risk of caesarean section [17 (15.5%) Vs. 39 (35.4%), p=0.002]. Apgar score at 1 and 10 minute were lower in cases compared to controls (p=0.0001).
Conclusion: Obese women are at increased risk of pregnancy induced obesity and associated with an increased risk of hypertension, gestational diabetes mellitus, thromboembolic disease and urinary tract infection.
Siega–Riz AM, Siega–Riz AM, Laraia B. The Implications of Maternal Overweight and Obesity on the Course of Pregnancy and Birth Outcomes. Matern Child Health J 2006; 10: S153–6.
Leddy MA, Power ML, Schulkin J. The Impact of Maternal Obesity on Maternal and Fetal Health. Rev Obstet Gynecol 2008; 1: 170–8.
Ramsay JE, Greer I, Sattar N. ABC of Obesity; Obesity and reproduction. BMJ 2006; 333: 1159–62.
Drife JO. Weight gain in pregnancy; Eating for two or just getting fat? Br Med J (Clin Res Ed). 1986; 293: 903–4.
Kleigman RM, Gross T. Perinatal problems of the obese mothers and her infant. Obstet Gynaecol 1985; 66: 299–305.
Robinson H, Tkatch S, Mayes DC, Bott N, Okun N. Is maternal obesity a predictor of shoulder dystotia? Obstet Gynaecol 2003; 101: 24–7.
Garbaciak JA, Richter M, Miller S, Barton JJ. Maternal weight and pregnancy complications. Am J Obstet Gynaecol 1985; 152: 238–45.
Baetan JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight & obese nulliparous women. Am J Pub Health 2001; 91: 436–40.
Catalano PM, Kirwan JP, Haugel–de Mouzon S, King J. Gestational Diabetes and insulin resistance: Role of short and long term implications for mother and fetus. J Nutr 2003; 133:S1674–83.
O’Sullivan JB. Body weight and subsequent Diabetes Mellitus. JAMA 1982; 248:949– 52.
Metzger BE, Cho NH, Roston SM, Radvany R. Prepregnancy weight and insulin secretion predict glucose tolerance five years after gestational diabetes mellitus. Diabetes care 1993; 16: 1598–605.
Sibai BM, Gordon T, Thom E, Caritis SN, Klebanoff M, McNellis D, et al. Risk factors associated with pre– eclampsia in healthy nulliparous women: A prospective multicenter study. The National Institute of Child Health and Human Development Network of Maternal– Fetal Medicine Units. Am J Obstet Gynecol 1995; 172: 642–8.
Edwards LE, Dicks WF, Alton IR, Hakanson EY. Pregnancy in the massively obese–course outcome and obesity prognosisof infants. Am J Obste Gynecol 1978; 131: 479–83.
Johnson SR, Kolberg BH, Varner MW, Railsback LD. Maternal obesity and pregnancy surgery. Gynecology & Obstetrics 1987; 164: 431–7.
Perlow JH, Morgan MA. Massive maternal obesity and perioperative cesarean morbidity. Am J Obstet Gynecol 1994; 170: 560–5.
Goodall PT, Ahn JD, Chapa JB, Hibbard JU. Obesity as a risk factor for failed trial of labor in patients with previous caesarean delievery. Am J Obstet Gynecol 2005; 192: 1423–6.
Nanan DJ. The obesity pandemic implications for Pakistan. PaK J Med Assoc 2002; 52: 342–6.
Sutherland HW, Stowers JM, Fisher PM. Detection of chemical gestational diabetes.In: Sutherland HW, Stowers JH. Carbohydrate Metabolism in pregnancy and the Newborn: Berlin; Springer–Verlage; 1979; 421–425.
Wildschut HIJ. Prepregnancy Antecedent of a high risk pregnancy. In: James DIC, Steer PJ, Weiner CP, Gonik B.High risk pregnancy: Management options. 3rd ed. Philadelphia: W.B. Saunders; 2006; 3–41.
Lumbardi DG, Barton JR, O`Brien JM, Istwan NK, Sibai BM. Does an obese prepregnancy body massindex influence outcome in pregnancies complicated by mild gestational hypertension remote from term? Am J Obstet Gynecol 2005; 192: 1472–7.
Barton JR,O`Brien JM,Bergaur N,Jacques DL,Sibai RM.Mild gestational hypertension remote from term: progression and outcome. Am J Obstet Gynecol 2001; 184: 979–83.
Gross T, Sokal RJ, King KC. Obesity in Pregnancy: Risks & outcome. Obstet Gynecol 1980; 56: 446–50.
Kirin TSU, Hemmadi S, Bethal J, Evans J. Outcome of Pregnancy in women with an increased body mass index. Br J Obstet Gynecol 2005; 112: 768–72.
Crane SS, Wojtowycz MA, Dye TD, Aubry RH, Artal R. Association between pre–pregnancy obesity and the risk of cesarean delivery. Obstet Gynaecol 1997; 89: 213–6.
Le Thai N, Lefebvre G, Stella V, Vauthier D, Sfoggia D, Goulon V, Darbios Y. Pregnancy and obesity. A case control study of 140 cases. J gynecol Obstet Biol Reprod (Paris) 1992; 21: 563–7.
O'Brien E, Coats A, Owens P, Petrie J, Padfield PL, Littler WA, et al. Use and Interpretations of Ambulatory Blood Pressure Monitoring: Recommendations of the British hypertension society. BMJ 2000; 320: 1128–34.
| Files | ||
| Issue | Vol 4, No 4 (December 2010) | |
| Section | Original Articles | |
| Keywords | ||
| Obesity Nutrition Women Pregnancy Postpartum Maternal health Diabetes Fetal health Birth outcome Pakistan | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
