Obesity and Classification Grades Analyzed in Pregnant Women at the High-Risk Prenatal Clinic: What is their Importance?

Abstract

Objective: Obesity is a frequent disease in pregnancy; however, the pathophysiological mechanisms that associate maternal obesity with unfavorable obstetric events during prenatal care, delivery and postpartum are not known, and therefore, adequate studies are lacking. Methods: Documentary and exploratory study was carried out with data obtained during consultation from 370 medical charts of patients seen at the high-risk prenatal outpatient clinic in a primary care unit, a reference center for six other units, in the city of Barueri, Sao Paulo, Brazil. In prenatal care, the guidelines of the Stork Network Program (Programa Rede Cegonha) of the Ministry of Health were used and include a pregnancy risk and obesity stratification system for pregnant women. Results: It was observed that 65% of the pregnant women were between 20 and 34 years old, 48.9% were white; most were in their first pregnancy. The mean gestational age at birth was 37.9 weeks. At the beginning of gestation, the women weighed an average of 71.2 kilograms, with a height of 159 cm and Body Mass Index (BMI) of 27.9 kg/m2. BMI with overweight or obesity prepregnancy had a lower risk of having a low-birth-weight NB (62% and 69%, respectively) when compared to pregnant women of adequate weight. Cesarean delivery prevailed, and among women with morbid obesity, the cesarean section rate was 90%. Conclusion: Epidemiological knowledge of this population is important for proposing policies to control chronic diseases that may affect pregnancy and to adjust the risk stratification according to the local reality.