2019, Number 10
Morbid obesity and fetal-maternal outcomes
Rodríguez-Vidal C, Álvarez-Silvares E, Rodríguez-Núñez R, Pérez-Adán M, Alves-Pérez MT
Language: Spanish
References: 0
Page: 647-659
PDF size: 207.66 Kb.
ABSTRACT
Objective: Establish whether morbid obesity during pregnancy is associated with increased maternal and perinatal morbidity and mortality (gestational diabetes, hypertensive states of pregnancy, premature delivery, fetuses with intrauterine growth retardation, macrosomia, neonatal death, etc.) in comparison with women with normal weight.Materials and Methods: Cohort study, with prospective follow-up and ambispective data collection of the Clinical History in the Ourense´s Hospital (Spain) between 2014 and 2017. Pregnant women with morbid obesity and non-obese random pregnant women were included for comparison. Parametric /nonparametric tests were performed to determine the potential association between the variables and to detect the relationship or interaction between the different variables, as well as the correlations.
Results: A total of 139 women were included (48 pregnant women with morbid obesity and 91 pregnant women without obesity). There was an increase in the annual incidence of pregnant women with morbid obesity. Patients with BMI ≥ 40 Kg/m2were significantly more likely to have gestational diabetes, requiring insulin therapy more frequently. A greater propensity to develop hypertensive states of pregnancy (mainly gestational hypertension) and gestational hypothyroidism. We found statistical differences in favor of induction and delivery by caesarean section in pregnant women with morbid obesity. There was a risk of 4.29 (95% CI:2.02-9.08) of a woman with morbid obesity ending her pregnancy by caesarean section. It stands out in the neonatal results, that the cohort with obesity presented an increase of macrosomic newborns, altered values of the Apgar test at the first minute and neonatal admission.
Conclusions: The incidence of pregnant women with morbid obesity in our environment has increased. Class III obesity during pregnancy increases the risk of maternal-fetal complications.