Pregnancy outcomes in super-obese women – an even bigger problem? A prospective cohort study

Files
M Nieuwoudt.pdf(205.45 KB)
Date
2014-08
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Health & Medical Publishing Group
Abstract
Objective. To investigate whether differences exist in adverse pregnancy outcomes between morbidly obese (body mass index (BMI, kg/m2) 40 - 49.9) and super-obese women (BMI ≥50). Methods. A prospective cohort study was undertaken at Tygerberg Hospital, a referral centre in the Western Cape Province of South Africa, of morbidly obese and super-obese pregnant women recruited from the antenatal clinic. Data were collected from the files 6 weeks after delivery. Primary outcomes included hypertension, diabetes mellitus and fetal macrosomia. Secondary outcomes included baseline characteristics, previous complications, antenatal and peripartum complications, and short-term neonatal outcomes. Results. Sixty-six morbidly obese and 46 super-obese women were enrolled. Super-obese women experienced significantly higher incidences of pre-eclampsia (24% v. 9%; p=0.03) and interuterine growth restriction (13% v. 2%; p=0.02) than morbidly obese women, and both groups had a high incidence of gestational diabetes (24% v. 24%; non-significant (NS)). Both super-obese and morbidly obese women experienced high rates of caesarean section (54% v. 41%; NS). In super-obese women these procedures lasted longer (50 v. 41 minutes; p<0.01) and there were more surgical complications (36% v. 7%; p=0.01). Prolonged admission (>3 days) after delivery was also more common in super-obese women (65% v. 42%; p=0.03). Conclusion. Super-obese women encounter more major pregnancy complications (especially hypertensive, pre-eclamptic and surgical) than morbidly obese women, emphasising the fact that these women should be managed at institutions with sufficient expertise.
Description
CITATION: Nieuwoudt, M., Van Der Merwe, J. L., Harvey, J. & Hall, D. R. 2014. Pregnancy outcomes in super-obese women – an even bigger problem? A prospective cohort study. South African Journal of Obstetrics and Gynaecology 2014;20(2):54-59. DOI:10.7196/sajog.820
The original publication is available at http://www.sajog.org.za/index.php/SAJOG/index
Keywords
Obesity in pregnant women, Super-obese, Obesity complications, Pregnancy complications, Pregnant women -- Physiology, Pregnant women -- Health and hygiene
Citation
Nieuwoudt, M., Van Der Merwe, J. L., Harvey, J. & Hall, D. R. 2014. Pregnancy outcomes in super-obese women – an even bigger problem? A prospective cohort study. South African Journal of Obstetrics and Gynaecology 2014;20(2):54-59. DOI:10.7196/sajog.820
URI
http://hdl.handle.net/10019.1/95725
Collections
Research Articles (Obstetrics and Gynaecology)