Obesity is associated with specific increased perinatal risks to mother and child. The study sets out to identify and assess the risk in a high NIDDM prevalence population. The obstetric outcomes
of 1691 women with a body weight >/+ 85 kg and a pre-pregnancy BMI >30 and their 1721 infants were statistically compared to similar parameters in the background population of 18717 maternities and 18974 births. Obese mothers were characteristically more likely to be older than 30 years of age [p<0.0001], multiparous [p<0.0001] with a history of previous miscarriages [p=0.003]. The antenatal period was more likely to be complicated by hypertensive disease [pre-existing and pregnancy induced; p<0.0001], and gestational diabetes [p<0.0001]. They were less likely to suffer from accidental haemorrhage [p=0.0074]. These antenatal problems were not simply a determinant of maternal age. They did not appear to have a significantly higher risk of pre-existing diabetes [p=0.3267] and did not require an increased risk of assisted reproduction [p=0.3953]. The multiple pregnancy rates were also not statistically increased [p=0.3121]. The obese women were also more likely to require obstetric interventions with induction of labour [p<0.0001] and Caesarean section [p<0.0001]. There was a statistically lower rate of operative deliveries [p=0.0007]. The preterm delivery rates were not different [p=0.947] between the two groups of women. The infants born to obese women were at a statistically higher risk for macrosomia [more than 4.0 kg; p<0.0001] and lower risk for low birth weight [under 2.5 kg; p=0.0248]. They also had a statistically higher risk for congenital malformations. There was a slightly higher risk for respiratory distress although the differences did not reach statistical significance [p=0.0596]. There was not any significantly increased risk for perinatal loss [p=0.8212], shoulder dystocia [p=0.5059], and low APGAR scores at five minutes [p=0.9989]. There were no differences in the male: female ratios [p=0.761]. Infants born to obese women were less likely to be solely breastfeed, though the differences did not reach statistical significance [p=0.0782]. It appears that the obese pregnant woman and her infant are predisposed to adverse short-term obstetric outcomes similar to those found in gestational diabetics. This relationship may reflect determinants of the "Metabolic Syndrome"
C. Savona Ventura ,M. Gatt ,
Short-term obstetric outcomes in obese Maltese women,
Int. J. Diabetes Metab. 2006;
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