The Adverse Impact of Maternal Obesity on Intrapartum and Perinatal Outcomes

Background. Confidential enquiries into maternal deaths in the UK have repeatedly highlighted increased maternal morbidity and mortality associated with maternal obesity. Objective. To determine the impact of increased body mass index (BMI) on intrapartum outcomes. Materials and Methods. A retrospective case-control analysis of intrapartum outcomes of the study group (100 women), with a BMI above 40 kg/m(2) (class III Obesity) at booking and a control group (100 women) with a booking BMI between 20 and 25 kg/m(2) was performed. Results. A statistically significant increase in delivery by caesarean section (OR 2.32, 95% CI 1.26-4.29), minor and major postpartum haemorrhage (OR 5.93, 95% CI 2.34-11.98, OR 16.11, 95% CI 2.08-125.09, resp.), perineal trauma (OR 2.59, 95% CI 1.44-4.69), and fetal macrosomia (OR 3.11, 95% CI 1.25-7.79) was noted in the study group. Babies also had an increased risk of having a lower APGAR scores in the study group as compared to the control group (OR 3.09, 95% CI 1.07-8.94). Conclusion. Women with a BMI > 40 kg/m(2) experience increased incidence of intrapartum complications and hence, input of skilled birth attendants during labour is essential to improve intrapartum outcomes.