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.