Effects of maternal obesity on fetal weight and obstetric outcomes in an African population

Abstract

Background: Maternal weight is one of the factors that influence obstetric outcome. Women therefore should enter pregnancy with a weight within the normal body mass index category, and stay within the recommended gestational weight gain guidelines for optimal outcome. The limited data on maternal obesity and its contribution to obstetric outcomes especially in the developing societies provoked the interest in this survey.

Objective: To determine the prevalence of first trimester maternal obesity, pattern of gestational weight gain and investigate the effects of maternal obesity on maternal and perinatal outcomes.

Methodology: This was a case control study of 282 pregnant women at a second tier missionary hospital in Southern Nigeria between 1^st July 2009 and 30^th June 2014. EPI INFO software was used for analysis with statistical significance set at P<.05.

Results: The prevalence of first trimester maternal obesity in this population was 28.2%. The obese mothers weighed more at booking and at term, had less gestational weight gain (8.2% vs. 19.3% and less body mass index (8.3% vs.19.6%). They were significantly older (t=5.8, P < 0.001), of higher parity (t=4.2, P <0.001) and had more gestational hypertension (OR 3.03, P <.003), caesarean births (OR 2.4, P <0.01), heavier neonates (P<0.001) and fetal macrosomia (OR 6.33, P<0.003).

Conclusion: Maternal obesity is a significant burden in Nigeria and is associated with excessive fetal weight with consequent adverse maternal and fetal outcomes. Quality preconception and prenatal intervention targeting optimal maternal weight is proffered.

Keywords: Gestational weight, Feto-maternal, Complications, Perinatal, Nigeria