Riffat Jaleel.
Impact of maternal obesity on pregnancy outcome.
J Surg Pak Jan ;14(1):2-6.

Objective: To determine the frequency of overweight and obese pregnant women and to determine maternal and perinatal outcome in women with high pre-pregnancy body mass index (BMI). Study design: Case Control study Place & Duration of study: Private Maternity Home at Karachi, from January 2006 to April 2008. Patients and Methods We included patients with parity between 0 to 4, booked before 10th week of pregnancy. They were followed regularly and delivered in the same facility. Exclusion criteria were multiple gestation, grand multigravidae and previous 2 or more caesarean sections. BMI calculated at booking visit 2 was used for reference. Patients with BMI > 23 kg/m were selected as study cases, while those 2 with BMI between 18.5 to 22.9 kg/m were taken as controls. Maternal and perinatal complications were studied. Data were entered and analyzed using SPSS version 15. Means with standard deviation were calculated for numerical variables and proportions for categorical variables. Significance of difference was calculated using Student t test, Chi square test and Fisher exact test where applicable. Results: Total number of deliveries were 864 during the study period. The BMI of 509 patients (58.9%) was > 23 kg/m at booking visit, while 249 (28.8%) had BMI > 25 kg/m . The number of patients excluded from study were 391 on the basis of exclusion criteria and / or incomplete data. The number of patients selected were 118 patients. An equal number of controls were selected for comparison. Family history of diabetes was present in 75.8% cases and 47.5% controls (p=0.000 ), while that of hypertension was present in 30.3% cases and 12.1% controls (p=0.002). Impaired glucose tolerance was found in 10.1% patients (p=0.001), gestational diabetes in 4% (p=0.121), pregnancy induced hypertension in 10.1% (p=0.297), urinary tract infection in 20.2% (p=0.014), vaginal candidiasis in 36.4% (p=0.000 ) and surgical wound infection in 2% ( p=0.242 ). 36.4% patients had caesarean delivery (p=0.064) while 11.1% had instrumental delivery (p=0.027). Shoulder dystocia was encountered in 4% patients (p=0.121) and 7.1% (p=0.170) experienced postpartum hemorrhage. The macrosomic babies were 16.2% (p=0.024) and 6.1% were born preterm (p=0.756). Conclusions: The burden of overweight and obese pregnant women is high. There is a strong association of high pre-pregnancy BMI with family history of diabetes and hypertension. It should be regarded as a high risk state because of its association with adverse obstetric outcome.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com