To Study the Fetomaternal Outcomes of Pregnancy with Obesity- Retrospective Case-Control Study

Abstract

Background: Increasing incidence has been seen among women of reproductive age with every one out of five women being affected by obesity. Obesity poses unfavorable outcomes for both mother and child causing ten percent of gestational diabetes and pre-eclampsia, neonatal deaths. Objective: To find the association of obesity in pregnancy with maternal and perinatal outcomes. Primary Objective: To investigate the association between maternal obesity during pregnancy and various fetomaternal outcomes. Primary Outcome: The occurrence of cesarean section deliveries, gestational diabetes, preeclampsia, macrosomia, low birth weight babies, and shoulder dystocia among pregnant women with obesity compared to non-obese pregnant women. The study will assess the relative risk and confidence intervals for all the described outcomes. Subject and Methods: This retrospective case-control study was performed in the Department of Obstetrics and Gynaecology, Kulsoom Bai Valika Hospital, site area, Karachi from February to August 2021. A total of 220 patients were included, 110 patients with a BMI equal to or more than 30 kg/m2 were exposed group and 110 cases BMI less than 30 kg/m2 were in the non-exposed group. A detailed history and examination, baseline investigations were carried out. Performa was given to patients of each group, and outcomes were recorded. Results: The average age of the patients was 28.73±6.52 years. The rate of cesarean section and PIH was 3 times more likely in obese groups than non-obese groups [RR=2.74 95%CI: 1.69-3.31] and [RR=3.08 95%CI: 2.11-4.49] respectively. The rate of GDM and preeclampsia was also 2 times more likely in the obese group than the non-obese group [RR=1.48 95%CI: 1.07-2.05] and [RR=2; 95%CI: 1.05-3.79] respectively. The rate of low birth weight was not statistically significant between obese and non-obese groups (p=0.053). While rate of macrosomia 7 times and Shoulder Dystocia time 5 more likely in obese groups than non- obese groups [RR=6.85; 95%CI: 3.24-14.48] and [RR=4.80; 95%CI: 2.56-8.99] respectively. Conclusion: Conclusion Obesity is a challenge of the present era for obstetricians, which is reaching the status of epidemic worldwide. This study shows that obesity in pregnant females is directly proportional to poor fetomaternal outcomes, therefore pregnant obese females should be managed as a high-risk case.