Pregnancy outcomes in a population with high prevalence of obesity: How bad is it?

Introduction: The prevalence of obesity and overweight in United Arab Emirates (UAE) reaches 39.9% among females and the WHO estimates that obesity prevalence will reach 44.6% among females by the year 2015. Objective: To evaluate the effect of varying degrees of maternal obesity on perinatal outcomes. Methods: Retrospective study of 1985 women grouped into 5 groups according to the body mass index (BMI) measurements in early pregnancy. Group 1 - BMI 18.5-24.9 (normal weight), Group 2 - BMI 25-29.9 (overweight), Group 3 - BMI 30-34.9 (obesity class I), Group 4 - BMI 35-39.9 (obesity class II), Group 5 - BMI 40 or more (obesity class III). The obstetric and perinatal outcomes were compared by creating multiple logistic regression models. Results: Morbidly obese women were about 5 times more likely to develop hypertensive disorders of pregnancy (OR = 4.97, 95% CI, 1.35-18.33, p = 0.016), 4 times more likely to develop gestational diabetes (OR 3.75, 95% CI, 1.83-7.69, p = 0.001), 3 times more likely to deliver post- term (OR 2.99, 95% CI1.35-6.65, p = 0.007), 3 times more at risk of delivering by caesarean section (OR 2.73, 95% CI, 1.61-4.65, p = 0.0001) and at a very high risk of delivering big babies, OR 17.30 (95% CI, 15.48-54.62, p = 0.001). Conclusion: Maternal obesity especially morbid obesity in early pregnancy is strongly associated with a number of obstetrical and perinatal complications. Pregnancies in obese women should be managed as high risk pregnancies with strategies for prevention, early detection and management of complications arising from obesity. Copyright (C) 2012, INDIACLEN. Publishing Services by Reed Elsevier India Pvt Ltd. All rights reserved.