Abstract: Background: Obesity is a global health problem. Rates of obesity in pregnancy are increasing, particularly in developed countries. The increasing global prevalence of overweight and obesity makes it more likely that a growing number of women with high body mass index (BMI) are becoming pregnant. The objective of this study was to assess antenatal, intra-partum complications, perinatal outcome in pregnant women with high BMI.
Methods: It is a prospective non-randomized descriptive study conducted in the department of obstetrics and gynecology in 250 Bedded General Hospital, Jhenaidah, Bangladesh from January to June 2024. Complications during pregnancy, labor, puerperium studied 25 pregnant women of BMI >25 as cases and controls 25 pregnant women with normal BMI. The outcome variables evaluated in study were rates of preeclampsia, gestational diabetes, cesarean delivery, failed induction, operative vaginal deliveries, birth weight, and postpartum infection.
Results: Total 50 cases in this study 17(68%) of normal pregnant and 15 cases (60%) of obese pregnant group women were of 20-25years age. 30 were primi and 20 were multi. Among 30 cases 14 cases (56%) from normal group and 16 cases (66%) from obese group were primi para 5 cases developed pre-eclampsia in this study. Among the 5 cases, 2 cases (4%) belong to normal group and 4 cases (16%) to obese group. 24 cases of normal group and 4 cases (16%) remained normotensive. In total 50 cases in this study, 34 cases had spontaneous labor and 16 cases needed induction. Among the 16 cases with induced labor, 5 cases (20%) were from normal BMI group and 11 cases (44%) were from obese group. Among the total number of 50 cases, 34 had normal vaginal delivery, 5 cases required out forceps and 11 cases were delivered by caesarean section. Out of the 5 cases with normal delivery, 2 (8%) cases were from normal BMI group, 4 cases were from obese group. Out of the 11 cases who delivered by caesarean section, 3 cases (12%) were from normal BMI group and 8 cases (32%) were from obese group. Pre-term labor is 8% among obese and 2% among control groups, a significant increase. Obese group had two-fold increase in induced labours and threefold increase in caesarean section rate. Among fetal complications macrosomia is the most common complication observed in this study, the incidence being 22% in obese group and 2% in control group, a eleven fold increase. Incidence of low APGAR score or fetal distress is increased by twofold.
Conclusions: Maternal BMI shows strong associations with pregnancy complications and outcome. Both maternal and fetal complications are increased.
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