Pregnancy outcomes in a population with high prevalence of obesity: How bad is it?

IntroductionThe prevalence of obesity and overweight in United Arab Emirates (UAE) reaches 39.9% among females and the WHO estimates that obesity prevalence will reach 44.6% among females by the year 2015.ObjectiveTo evaluate the effect of varying degrees of maternal obesity on perinatal outcomes.MethodsRetrospective study of 1985 women grouped into 5 groups according to the body mass index (BMI) measurements in early pregnancy. Group 1 – BMI 18.5–24.9 (normal weight), Group 2 – BMI 25–29.9 (overweight), Group 3 – BMI 30–34.9 (obesity class I), Group 4 – BMI 35–39.9 (obesity class II), Group 5 – BMI 40 or more (obesity class III). The obstetric and perinatal outcomes were compared by creating multiple logistic regression models.ResultsMorbidly obese women were about 5 times more likely to develop hypertensive disorders of pregnancy (OR = 4.97, 95% CI, 1.35–18.33, p = 0.016), 4 times more likely to develop gestational diabetes (OR 3.75, 95% CI, 1.83–7.69, p = 0.001), 3 times more likely to deliver post-term (OR 2.99, 95% CI1.35–6.65, p = 0.007), 3 times more at risk of delivering by caesarean section (OR 2.73, 95% CI, 1.61–4.65, p = 0.0001) and at a very high risk of delivering big babies, OR 17.30 (95% CI, 15.48–54.62, p = 0.001).ConclusionMaternal obesity especially morbid obesity in early pregnancy is strongly associated with a number of obstetrical and perinatal complications. Pregnancies in obese women should be managed as high risk pregnancies with strategies for prevention, early detection and management of complications arising from obesity.