Effect of obesity on the outcome of pregnancy in primigravida patients: an Iraqi experience
Keywords:BMI, Cesarean section, Mode of delivery, Obesity, Pregnancy, Primigravida, Second stage of labor
Background: A parallel rise in the rate of obesity in women in reproductive age; and cesarean section as outcome of pregnancy is noticed in the last years in our society. It is unknown whether this dual rise is related or not. The impact is more evident on primigravida patients, so authors perform this study to assess the impact of obesity on the outcome of pregnancy in primigravida patients in a major obstetrics hospital.
Methods: A prospective controlled study was conducted in Ibn Al-Balady obstetrics hospital. It included 121 primigravida patients who were divided into 3 groups according to WHO BMI categories: normal, overweight, and obese. The mode of delivery of these patients is recorded and was assessed in relation to BMI.
Results: About 17% of the patients were obese and they needed more emergency CS as a mode of delivery than normal BMI patients (p<0.01). They also had longer second stage of labor (p<0.01) and delivered babies with higher birth weight that the normal group (p<0.05).
Conclusions: Obesity constitutes a growing challenge on the outcome of pregnancy, duration of second stage of labor and baby birth weight in primigravida patients. Women who are getting pregnant for the first time should be advised to lower their BMI as a safety measure to avoid emergency cesarean section.
Weiss JL, Malone FD, Emig D, Ball RH, Nyberg DA, Comstock CH, et al. Obesity, obstetric complications and cesarean delivery rate-a population based screening study. Am J Obstet Gynecol. 2004;190: 1091-7.
Kabiru W, Raynor B. Obstetric outcomes associated with increase in BMI category during pregnancy. Am J Obstet Gynecol. 2004;191:928-32.
Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord. 2001;25:1175-82.
Martorell R, Khan LK, Hughes ML, Grummer-Strawn LM. Obesity in women from developing countries. Europ J Clin Nutr. 2000;54(3):247-52.
Al-Twail NG, Abdulla NM, Abdul Ameer AJ. Prevalence of and factors associated with overweight and obesity among a group of Iraqi women. Eastern Mediter Health J. 2007;13(2):420-9.
Al-dobony SJ. Rate, Indications and risk factors of cesarean section in maternity hospital in Baghdad city. Iraqi Board of Medical Specialization, Community Medicine. 2009.
Ministry of Health: Multiple Indicator Cluster Survey Final Report, Iraq 2006 ( MICS 3), Central Organization for Statistics and Information Technology, Kurdistan Regional Office. Iraq: United Nations Children Fund; 2007.
Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. J Chronic Dis. 1972;25(6):329-43.
Poobalan AS, Aucott LS, Gurung T, Smith WCS, Bhattacharya S. Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women- systematic review and meta-analysis of cohort studies. Obes Rev. 2009;10:28-35.
O’dawyer V, O’Kelly S, Monaghan B, Rowan N, Farah N, Turner M. Maternal obesity and induction of labor. Acta Obstet Gynecol Scand. 2013;92:1414-8.
Shafer E. The effect of marriage on weight gain and propensity to become obese in the African American community. J Fam Issues. 2010;31:1166-82.
Barau G, Robillard PY, Hulsey TC, Dedecker F, Laffite A, Gérardin P, et al. Linear association between aternal body mass index and risk of cesarean section in term deliveries. BJOG. 2006;113:1173-7.
Verdiales M, Pacheco C, Cohen WR. The effect of maternal obesity on the course of labor. J Perinat Med. 2009;37:651-5.
Chu SY, Schmid CH, Dietz PM, Callaghan WM, Lau J, Curtis KM. Maternal obesity and risk of cesarean delivery: a meta-analysis. Obes Rev. 2007;8:385-94.
Roman H, Goffinet F, Hulsey TF, Newman R, Robillard PY, Hulsey TC. Maternal body mass index at delivery and risk of caesarean due to dystocia in low risk pregnancies. Acta Obstet Gynecol. 2008;87:163-70.
Barau G, Robillard PY, Hulsey TC, Dedecker F, Laffte A, Gérardin P, et al. Linear association between maternal pre-pregnancy body mass index and risk of caesarean section in term deliveries. Br J Obstet Gynaecol. 2006;113:1173-7.