Maternal Obesity and Its Effect in Late Pregnancy and Labour

Mahmoud M. Abdo*, Hossam Aldin H. Kamel, Abdel Sattar M. Ibrahim,

Maternal Obesity and Its Effect in Late Pregnancy and Labour

Document Type : Original Article

Author

Hossam Aldin H. Kamel, Abdel Sattar M. Ibrahim, Mahmoud M. Abdo*

Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University

Abstract

Background: In recent years, obesity has become a major public health problem and its prevalence is increasing at an alarming pace. Moreover, this problem has affected children and adolescents in marked fashion with a higher prevalence in females than in males.
Objective: To evaluate the effect of maternal obesity on length of gestation and mode of delivery and subsequent intrapartum and neonatal complications.
Methods: This prospective cohort study involved a total no. of 600 women with singleton pregnancies delivered in the period between December 2011 and July 2012 and were categorized into three groups according to their BMI; normal weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2) and obese (≥30 kg/m2). The main outcome measures were length of gestation, mode of delivery, risk of delivery and neonatal complications in overweight and obese women versus normal weight women. Results: Obese women had a significantly increased risk of post-term pregnancy and higher rate of induction ending in caesarean section

compared with women of normal weight. Again, there was a significantly longer median length of first stage, increased incidence of second-degree tear and significantly increased risk of low Apgar score. However, the incidence of postpartum haemorrhage and third-degree tear were similar in all body mass index categories. As regard shoulder dystocia, there was a trend towards increased incidence with increasing BMI for primiparous women but just failed to reach significance (P=0.05). There was a trend towards increased incidence of macrosomia with increasing BMI category (P=0.074) this trend was significantly true for primiparous women (P=0.047), but no trend was observed for analysis restricted to multiparous women.
Conclusion: Increasing BMI is associated with increased incidence of post-term pregnancy, failed progress of labour, labour induction, CS delivery, low Apgar score and macrosomic babies.

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