Maternal and Neonatal Outcomes among Obese Pregnant Women in King Abdulaziz University Hospital: A Retrospective Single-Center Medical Record Review

Abstract

Intoruction: Pregnancy results in different physiological changes to the pregnant body resulting in weight gain. This added weight can result in poor pregnancy outcomes in obese women.

Aim: To assess the adverse maternal and neonatal outcomes among obese pregnant women.

Methods: This is a retrospective record review conducted on obese pregnant women who delivered in the last five years attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Therefore, for analysis we used the following; 1- descriptive analysis, 2- Chi-square test, Pearson correlation, independent t-test, and one-way ANOVA to test the difference in obese and adverse pregnancy outcomes. Advance statistics such as binary, and multinomial logistic regression were used to examine the relationship between obesity and all adverse pregnancy outcomes.

Results: A total of 1037 obese pregnant women were enrolled in our study including 620 (59.8%) obese in class I (30-34.9), 262 (25.3%) obese in class II (35-39.9), and 155 (14.9%) obese in class III (40). About 74.73% of the population were Saudis. The average age was 31.96 (5.79) years. Out of 1037 obese pregnant women, 449 did develop undesired antepartum outcomes, while 729 and 163 had adverse neonatal, and postpartum outcomes. Antepartum variables such as preeclampsia, gestational diabetes mellitus, impaired glucose tolerance test, antiphospholipid syndrome, premature rupture of membranes, placenta previa, anemia, urinary tract infection, and oligohydramnios, and rate of Cesarean section were significantly associated with obesity (P<0.05). Postpartum variables such as vaginal laceration, perianal laceration, postpartum hemorrhage, and endometritis were also significantly associated with obesity (P<0.05). Moreover, adverse neonatal outcomes such as low APGAR scores at 1 and 5 minutes, birthweight, gestational age, admission to neonatal intensive care unit, intrauterine fetal death, and neonatal death, were significant significantly associated with obesity (P<0.05).

Conclusion: As our study demonstrated, maternal obesity resulted in adverse outcomes for the mother and fetus. Hence, to yield a better outcome for these women and their offspring, periconceptional counseling, conducting health education, and comprehensive plan prior to their pregnancy should be enforced.

Keywords: Maternal; Neonatal; Obesity; Pregnancy Outcomes; Saudi Arabia.