Maternal obesity and its outcome in the fetus
Keywords:Maternal obesity, Outcome, Overweight, Fetus
Background: Maternal obesity increases the risk of gestational diabetes, preeclampsia and caesarian sections. We conducted this study to find out the outcome of maternal obesity on pregnancy and neonates.
Methods: 1398 pregnant ladies who came into the Gynaecology department between the age of 18-40 were included into the study. Demographic details including age, height and weight were noted. BMI was calculated bases on the weight and height of the patients. Routine blood tests were performed. If random blod sugar was elevated, OGTT was done to identify gestational diabetes.
Results: The prevalence of overweight/ obese patients was 27.7%, of which, 72.1% were overweight, 23.1% were obese and 30 7.5% were severely obese. Most of the patients with overweight/obese over the age of 30 years. The most common complication among these women was hypertension, followed by post partum haemorrhage. Gestational diabetes was observed among 19.1% of the cases. 62.3% of them underwent caesarian sections and preeclampsia was seen in 35.9% patients. Macrosomia and higher birth weight was seen in most of the neonates.
Conclusions: Hypertension, preeclampsia and gestational diabetes are the common outcomes in the mothers leading largely to caesarian sections and higher birth weight and macrosomia is seen in neonates.
Leddy MA, Power ML, Schulkin J. The Impact of Maternal Obesity on Maternal and Fetal HealthRev Obstet Gynecol. 2008;1(4):170-8.
Musaiger AO, Al-Hazzaa HM. Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region. Int J Gen Med. 2012;5:199-217.
Heslehurst N, Ells LJ, Simpson H, Batterham A, Wilkinson J, Summerbell CD. Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36 821 women over a 15-year period. BJOG. 2007;114:187-94.
Institute of Medicine/National Research Council (Committee to Reexamine IOM Pregnancy Weight Guidelines, Food and Nutrition Board and Board on Children, Youth and Families) 2009 Weight gain during pregnancy: reexamining the guidelines. Washington, DC; National Academies Press.
Schiessl B, Beyerlein A, Lack N, von Kries R. Temporal trends in pregnancy weight gain and birth weight in Bavaria 2000-2007: slightly decreasing birth weight with increasing weight gain in pregnancy. J Peninat Med. 2009;37:374-9.
Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, Yousef M, Sabico SL, et al. Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (riyadh cohort 2): a decade of an epidemic. BMC Med. 2011;9:76.
El-Gilany AH, El-Wehady A. Prevalence of obesity in a Saudi obstetric population. Obes Facts. 2009;2:217-220.
Bendixen H, Holst C, Sorensen TI, Raben A, Bartels EM, Astrup A. Major increase in prevalence of overweight and obesity between 1987 and 2001 among Danish adults. Obes Res. 2004;12:1464-72.
Visscher TL, Seidell JC. The public health impact of obesity. Annu Rev Public Health. 2001;22:355-75.
Lynch CM, Sexton DJ, Hession M, Morrison JJ. Obesity and mode of delivery in primigravid and multigravid women. Am J Perinatol. 2008;25:163-7.
Rooney B, Schauberger C. Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol. 2002;100:245-52.
Johnson JM, Wilson RD, Singer J, Winsor E, Harman C, Armson BA. Technical factors in early amniocentesis predict adverse outcome. Results of the Canadian early (EA) versus midtrimester (MA) amniocentesis Trial. Prenatal Diagn. 1999;19:732-8.
American Diabetes Association: Gestational diabetes mellitus. Diabetes Care. 2004;27(1):S88-S90
Casey BM, Lucas MJ, Mcintire DD, Leveno KJ. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol. 1997;90:869-73.
Saydah SH, Chandra A, Eberhardt MS. Pregnancy experience among women with and without gestational diabetes in the U.S., 1995 National Survey of Family Growth. Diabetes Care. 2005;28:1035-40.
Ben-Haroush A, Yogev Y, Hod M. Epidemiology of gestational diabetes mellitus and its association with type 2 diabetes. Diabet Med. 2004;21:103-13.
Gillman MW, Rifas-Shiman S, Berkey CS, Field AE, Colditz GA. Maternal gestational diabetes, birth weight, and adolescent obesity. Pediatrics. 2003;111:e221-e226.
Sirimi N, Goulis DG. Obesity in pregnancy. Hormones (Athens). 2010;9:299-306.
Ruager-Martin R, Hyde MJ, Modi N. Maternal obesity and infant outcomes. Early Hum Dev. 2010;86:715-22.
Vasudevan C, Renfrew M, McGuire W. Fetal and perinatal consequences of maternal obesity. Arch Dis Child Fetal Neonatal Ed. 2011;96:378-82.
McGuire W, Dyson L, Renfrew M. Maternal obesity: consequences for children, challenges for clinicians and carers. Semin Fetal Neonatal Med. 2010;15:108-12.
Papachatzi E, Dimitriou G, Dimitropoulos K, Vantarakis A. Pre-pregnancy obesity: maternal, neonatal and childhood outcomes. J Neonatal Perinatal Med. 2013;6:203-16.
Galliano D, Bellver J. Female obesity: short- and long-term consequences on the offspring. Gynecol Endocrinol. 2013;29:626-31.
Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1:11-25.
Ali HS, Lakhani N. Effect of obesity and its outcome among pregnant women. Pak J Med Sci. 2011;27(5):1126-8.
Shafi S, Rao MS, Soomro IBM. The effect of lifestyle and socio-economic factors in the development of obesity in young adults. Pak J Med Res. 2004;43:65-9.
Leung TY, Leung TN, Sahota DS, Chan OK, Chan LW, Fung TY, et al. Trends in maternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinese women. BJOG. 2008;115:1529-37.
Callaway LK, Prins JB, Chang AM, McIntyre HD. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust. 2006;184:56-9.
Cameron AJ, Welborn TA, Zimmet PZ, Dunstan DW, Owen N, Salmon J, et al. Overweight and obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust. 2003;178:427-32.
Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet. 2006;93:269-74
O’Brien TE, Ray JG, Chan WS. Maternal body mass index and the risk of preeclampsia. A systematic overview. Epidemiology. 2003;14:368-74.
Galtier-Dereure F, Montpeyroux F, Boulot P, Bringer J, Jaffiol C. Weight excess before pregnancy: complications and cost. Int J Obes Relat Metab Disord. 1995;19:443-8.
Edwards LE, Hellerstedt WL, Alton IR, Story M, Himes JH. Pregnancy complications and birth outcomes in obese and normalweight women: effects of gestational weight change. Obstet Gynecol. 1996;87:389-94.
Gross T, Sokol RJ, King KC. Obesity in pregnancy: risks and outcome. Obstet Gynecol. 1980;56:446-50.
Sherrard A, Platt RW, Vallerand D, Usher RH, Zhang X, Kramer MS. Maternal anthropometric risk factors for caesarean delivery before or after onset of labor. BJOG. 2007;114:1088-96.
Chu SY, Kim SY, Lau C. Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol. 2007;197:223-8.
Arendas K, Qin Q, Gruslin A. Obesity in pregnancy: Preconceptional to postpartum consequences. J Obstet Gyaenecol Can. 2008;30:477-88.
Sewell MF, Huston-Presley L, Super DM, Catalano P. Increased neonatal fat mass, not lean body mass, is associated with maternal obesity. Am J Obstet Gynecol. 2006;195:1100-3.
Jensen DM, Damm P, Sorensen B, Molsed-Pedersen L, Westergaard JG, Ovesen P. Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant danish women. Am J Obstet Gynecol. 2003;189:239-44.