DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193043

Associated comorbidities with obesity in pregnancy and its feto-maternal outcome

Rupam Sanjay Jain, Sneha D. Shirodkar

Abstract


Background: Obesity is an evolving risk factor in the modern day - a rising global epidemic reported to cause many problems in the pregnant woman - causing ill effects to both the mother and the fetus. Managing the comorbidities associated with obesity is a challenge in obstetric care.

Methods: This prospective observational cohort study was conducted at a tertiary care institute over a period of 2 years. 50 antenatal patients fulfilling the inclusion criteria were studied after taking informed consent. The various maternal, fetal and neonatal outcomes were noted to examine the magnitude and significance of the effect of BMI.

Results: Obese women have a higher prevalence of infertility and are considered a high-risk state because pregnancy is associated with a higher risk of pre-eclampsia, gestational diabetes mellitus, preterm labour, increased operative and caesarean deliveries, post-partum haemorrhage, post-partum infectious morbidities and a higher incidence of anesthetic and post-operative complications in these deliveries. Neonatal complications include congenital anomalies, fetal macrosomia leading to birth injuries, preterm births and still births. Technical difficulties are faced by the obstetricians while operating and by the anesthesiologists while induction.

Conclusions: Considering the adverse effects of obesity on pregnancy outcomes, pre-pregnancy counseling should be done for all overweight and obese females planning conception signifying the negative impact of obesity on maternal and fetal outcome.


Keywords


Body mass index, Diabetes mellitus, Gestational diabetes mellitus, Hypertension, Lower segment caesarean section, Pregnancy induced hypertension

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References


Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004;103(2):219-24.

Begum KS, Sachchithanantham K, De Somsubhra S. Maternal obesity and pregnancy outcome. Clin Exp Obstet Gynecol. 2011;38(1):14-20.

Seligman LC, Duncan BB, Branchtein L, Miranda Gaio DS, Mengue SS, Schmidt MI. Obesity and gestational weight gain: Cesarean delivery and labor complications. Rev Saude Publica. 2006;40(3):457-65.

Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol. 2008;1(4):170-8.

Lashen H, Fear K, Sturdee DW. Obesity is associated with increased risk of first trimester and recurrent miscarriage: Matched case-control study. Hum Reprod. 2004;19(7):1644-6.

Asim SS, Naeem H. Pregnancy with obesity -a risk factor for PIH. J Liaquat Univ Med Heal Sci. 2010;9(3):125-9.

Han C, Li C, Mao J. High body mass index is an indicator of maternal hypothyroidism, hypothyroxinemia, and thyroid-peroxidase antibody positivity during early pregnancy. BioMed Research Int. 2015:Article ID 351831.

Halloran DR, Cheng YW, Wall TC, Macones GA, Caughey AB. Effect of maternal weight on postterm delivery. J Perinatol. 2012;32(2):85-90.

Cnattingius S, Villamor E, Johansson S, Bonamy A-KE, Persson M, Wikström AK, et al. Maternal obesity and risk of preterm delivery. JAMA. 2013;309(22):2362.

Wolfe KB, Rossi RA, Warshak CR. The effect of maternal obesity on the rate of failed induction of labor. Am J Obstet Gynecol. 2011;205(2).

Marshall NE, Guild C, Cheng YW, Caughey AB, Halloran DR. The effect of maternal body mass index on perinatal outcomes in women with diabetes. Am J Perinatol. 2014;31(3):249-56.

Fitzsimons KJ, Modder Mrcog J. Obesity in pregnancy: risks and management. MedSci IA. 2009;52-62.

Van Der Steeg JW, Steures P, Eijkemans MJC, Habbema JDF, Hompes PGA, Burggraaff JM, et al. Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women. Hum Reprod. 2008;23(2):324-8.

Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health. 2001;91(3):436-40.

Chu SY, Callaghan WM, Kim SY, Schmid CH, Lau J, England LJ, et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007;30(8):2070-6.

Norman SM, Tuuli MG, Odibo AO, Caughey AB, Roehl KA, Cahill AG. The effects of obesity on the first stage of labor. Obs Gynecol. 2012;120(1):130-5.

Durnwald P, Ehrenberg CM, Mercer HM, Brian, Durnwald CP, Ehrenberg HM, et al. The impact of maternal obesity and weight gain on vaginal birth after cesarean section success. Am J Obstet Gynecol. 2004;191:954-57.

Arabin B, Stupin JH. Overweight and obesity before, during and after Pregnancy: Part 2: Evidence-based Risk Factors and Interventions. Geburtshilfe Frauenheilkd. 2014;74(7):646-55.

Vinayagam D, Chandraharan E. The adverse impact of maternal obesity on intrapartum and perinatal outcomes. ISRN Obstet Gynecol. 2012;2012:939762.

Usha Kiran TS, Hemmadi S, Bethel J, Evans J. Outcome of pregnancy in a woman with an increased body mass index. BJOG An Int J Obstet Gynaecol. 2005;112(6):768-72.

Sebire N, Jolly M, Harris J, Wadsworth J, Joffe M, Beard R, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes. 2001;25:1175-82.