Obesity and its obstetric implications

Obesity has long been regarded as an obstetric hazard. This study identified 300 primipara patients aged 20-29 years who were classified according to the estimated pre-pregnancy Body Mass Index (BMI). The study population was sub-divided into the lean (BMI < 25 kg/m2, n = 189), the overweight group (BMI 25-29, n = 73), and the obese group (BMI > 30, n = 38). The obese group had a statistically higher incidence of hypertensive disease when compared to the lean group. They also had a statistically higher incidence of oedema, glycosuria, vaginal infections and impaired glucose tolerance. There was no statistical difference in the incidence of a past history of a fetal loss, and a history of vaginal bleeding in the first two trimesters. Antenatal follow-up of the pregnancy in the obese group was more difficult requiring more frequent ultrasonic investigations. The obese group had a tendency towards a prolonged labour, but there did not appear to be any difference in the mode of delivery. Infants of obese women had significantly lower 1 min APGAR scores. These infants were significantly larger than those born to lean women. There was no increase in the incidences of post-partum problems.