Comparing Pregnancy Outcomes in Obese Diabetic and Obese Non Diabetic Women - A Retrospective Study [33C

Abstract

INTRODUCTION: The purpose of this study was to compare the pregnancy outcomes between obese pregnant women with and without diabetes. METHODS: Data from labor and delivery records gathered between 1/1/2010 and 9/1/2013 were studied. Women with BMI greater than 40 and with either gestational or type I diabetes mellitus (DM) were included and separated into two groups: Obese with DM (Group 1) and Obese without DM (Group 2). RESULTS: Compared to group 2: 23% of Group 1 delivered prematurely vs 14% (P < .05). Group 1 had cesarean deliveries 94% of the time vs 55% (P < .05). NICU admissions occurred in 14% of Group 1 vs 8% (P < .05) Neonates had a lower neonatal weight (3409 g ± 811 vs 3270 g ± 703 P < .05), slightly lower Apgar scores (7.0 ± 2.0 vs 7.4 ± 1.6) and neonatal pH (7.23 ± 0.9 vs 7.26 ± 0.18) compared to Group 2. 14 % of Group 1 patients developed preeclampsia vs 8% (P < .05). There was no significant difference in intrauterine fetal demise rates or shoulder dystocia rates between the two groups. CONCLUSION: In our study, women who are obese with DM had a higher risk of undergoing a cesarean section, delivering prematurely, developing preeclampsia, having a NICU admission, low fetal weight, low Apgar scores, and pH compared with obese women with no DM. This highlights the importance of recognizing and treating both obesity and DM in pregnancy as it has a large impact in both maternal and neonatal morbidity, as well as healthcare cost.