Pregnancy Outcome in the Obese Nigerian

Abstract

Background: An adult is considered obese if the body mass index (BMI) is 27 kg/m2 or more. Until now, obesity has been a problem of developed countries, but it is gradually spreading to the developing world. This is a cause for concern since obesity is a predisposing factor for many chronic diseases that will in turn affect pregnancy. Objectives: This study was undertaken to determine the influence of obesity on pregnancy outcome. Study Design And Setting: A prospective study in a federal medical centre in Nigeria. Method: Between January 1999 and December 2001, a total of 220 pregnant women with BMI of 27 kg/m2 or more who registered for antenatal care at the federal medical centre were identified. A control group (BMI less than 27 kg/m2) matched for age, educational status, parity and social class were selected and various maternal and perinatal variables were compared between the groups. Results: Antenatal attendances by both groups were generally poor and ignorance was a major factor. Obesity was associated with increasing parity and higher social class. It frequently results in an increased incidence of hypertension (p=0.0001), diabetes mellitus (p=0.0001), caesarean section (p<0.0001), obstructed labour (p=0.02), and prolonged duration of hospital stay (p<0.0001). Also the babies of these obese mothers are significantly more likely to have adverse perinatal outcome including macrosomia (58.2% vs 12% p<0.0001), birth asphyxia (27.3% vs 9% p<0.0001), birth trauma (10% vs 1% p<0.0001), neonatal admission to intensive care unit (31.8% vs 2.5% p<0.0001), and higher perinatal mortality (10.5% vs 2% p=0.0004). Conclusion: Pregnancy in obese women presents a certain amount of risk and there is need for close surveillance to reduce these obesity-related complications in pregnancy. This is achievable through multidisciplinary antenatal management involving the obstetrician, physician, neonatologist, dietitian and the social health worker.