[Relationship of cholelithiasis with obesity in pregnancy]

The aim of investigation was to study the influence of obesity on the development of cholelithiasis and chronic cholecystitis in pregnant patients. The type of investigation was case-control study. Inclusion criteria were cholelithiasis and chronic cholecystitis. Exclusion criteria were severe maternal diseases (preeclampsy, eclampsy, haemorrhagia) during pregnancy and in past. The main group consisted of 30 cases. For each case 2-4 pregnant patients served as control. Obesity was assessed by body mass index (BMI), and visceral obesity before pregnancy--by waist circumference (WC, criterium of WC>88 cm). In main group obesity by BMI was observed in 19 cases (63.3%), in control group--in 18 subjects (20.0%); therefore statistically significant odds ratio was OR=6.90 (95%CI--2.80/17.07). In main group obesity by WC was observed in 12 cases (40.0%), in control group--in 18 subjects [20.0%; OR=2.67 (95%CI--1.09/6.52)]. Increment of BMI during pregnancy in main group was 7.5+/-1.6 kg/m2; in control group--4.5+/-1.6 kg/m2 (p<0.001). As for WC increment during pregnancy, in main group it was 23.2+/-1.9 cm; and in control--18.1+/-3.8 cm (p<0.001). BMI, WC values and their increment are significantly increased in patients with diseases of gall bladder during pregnancy. Physiological dyslipidemia during pregnancy is more aggravated, but in patients with diseases of gall bladder lipid characteristics are even greater deteriorated.