To determine whether morbidly obese women have an increased risk of pregnancy complications and adverse perinatal outcome.
In a retrospective study, 2472 women with morbid obesity, defined as a body mass index (BMI) more than 40 were compared with normal weight women (BMI 20-25). Fisher and Student tests were used for statistical analysis.
In the group of morbidly obese mothers (BMI greater than 40) as compared with the normal weight mothers, there was an increased risk of the following outcomes: gravidic hypertension (7.7 vs 0.5%; p<0.05). preeclampsia (11.5 vs 2%; p<0.05), gestational diabetes (15.4 vs 1.8%; p<0.05), cesarean delivery (50 vs 15.4%; p<0.05), and macrosomia (42.3 vs 10.3%; p<0.05). However, we noted a lower rate of prematurity in the obese group (0 vs 11%). Even when morbidly obese women with preexisting diabetes and chronic hypertension were excluded from the analysis, significant differences in the perinatal outcomes still persisted.
Morbid obesity appears to be an independent risk factor for perinatal and gestational complications.
"Additionally , women in group 4 were treated as a separate group despite the low number (n = 25). Morbidly obese women generally have higher complication rates than do obese women with a BMI between 30 and 40   ; however, the small sample size of this group limited the ability to observe significant differences compared with the reference group (group 1). Further, the study population originated from one department, which could have hampered the generalizability of the results. "
[Show abstract][Hide abstract] ABSTRACT: As a result of the ongoing obesity epidemic, obstetricians worldwide will be forced to deal with more obese, and even morbidly obese, pregnant women. These women have an increased risk of gestational hypertension, pre-eclampsia, gestational diabetes and stillbirth. Obese women are also more likely to have prolonged labor, cesarean deliveries, macrosomic infants and infants with shoulder dystocia. It is a major obstetric challenge to inform obese women about these potential risks in clear terms and, at a later date, to solve the acute obstetric problems concerning these patients during delivery. Pregnancy could be seen as a window during which women are more open to counseling about the risks of being obese and are more likely to make behavioral changes that may persist and improve their health later in life.
Expert Review of Obstetrics & Gynecology 08/2006; 1(1):73-80. DOI:10.1586/17474188.8.131.52
[Show abstract][Hide abstract] ABSTRACT: The growing epidemic of obesity in our society has become a major public health issue, with serious social and psychological consequences in addition to the physical health implications. Obesity has reached epidemic proportions globally with a similar rise in prevalence among women in the reproductive age group. This has critical consequences for fetal and maternal health in the antepartum, intrapartum and postpartum periods. The aims of this study were to summarise the implications of maternal obesity on maternal, fetal and neonatal health and to recommend good practice guidelines on the management of this problem. The authors highlight the need for good quality interventional research on maternal obesity while identifying avenues with potential scope for future research in this context.
BJOG An International Journal of Obstetrics & Gynaecology 11/2006; 113(10):1134-40. DOI:10.1111/j.1471-0528.2006.01045.x · 3.45 Impact Factor
Rene L Olvera, Douglas E Williamson, Susan P Fisher-Hoch, Kristina P Vatcheva, Joseph B McCormick
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