PREGNANCY IN OBESE WOMEN: OBSTETRIC AND PERINATAL OUTCOMES
Main Article Content
Abstract
The aim of the reseach – to assess the obstetric and perinatal outcomes structure and frequency obstetric and perinatal outcomes among obese pregnant women.
Materials and methods. First (retrospective) stage: 150 birth histories were selected, 52 patients with obesity (group I) and 98 pregnant women with normal body mass index (group II). Second (prospective cohort) stage is case-control study has contained blood serum C-reactive protein determinationin 20 women with obesity and in 30 with normal body mass index. Statistical data processing was performed using MedCalc Version 18.2.1 software (license Z2367-F3DD4-83E2E8-A6963-ED902) using nonparametric statistics methods.
Results. In group I patients were significantly older than in group II (30.5 [27.5-34.5] and 27 [25.0-32.0]; p = 0.0001). Somatic diseases were hypertensive syndrome (40.3% and 6.3%; p < 0,001) and urinary system infectious diseases (27.8% and 15.6%; p = 0.04) were found more often. Among obese patients, there was a high proportion of multiparous women (75% and 36.7%; p = 0.001), with a history of miscarriage (70.8% and 50%; p = 0.007), infertility (8.3% and 1.6%; p = 0.05) and those who had orerative abdoninal delivery (41.6% and 15.6%; p = 0.001). In Group I pregancy complicatioma were gestational arterial hypertension (22.2% and 7.8%; p = 0.008), preeclampsia (22.2% and 5.4%; p = 0.001), gestational diabetes (29.2% and 9.4%; p = 0.0006), intrauterine growth restriction (6.9% and 0.8%; p = 0.004), perinatal hypoxia (38.9% and 17.9%; p = 0.003). C-reactive protein concentration in patients I group was significantly higher and steadily increased, reaching the maximum level in the third trimester. Newborns of obese mothers more often had large or small body weight for the gestational age and were more often transferred to the second nursing stage.
Conclusion. Pregnancy in obese patients is associated with a higher incidence of obstetric and perital complications.
Keywords
Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
Alfyorova VI, Mustafina SV. Prevalence of obesity in the adult population of the Russian Federation (literature review). Obesity and metabolism. 2022; 19(1): 96-105. Russian (Алферова В.И., Мустафина С.В. Распространенность ожирения во взрослой популяции Российской Федерации (обзор литературы) //Ожирение и метаболизм. 2022. Т. 19, № 1. С. 96-105.) doi: 10.14341/omet12809
Kozubenko OV, Men'shchikova YuV, Turchaninova MS, Men'shchikov MP, Vil'ms E.A. Hygienic characteristics of changes in the nutritional status of the adult population of the Omsk region during the implementation of the national project «Demography». Fundamental and Clinical Medicine. 2024; 9(3): 29-38. Russian (Козубенко О.В., Меньщикова Ю.В., Турчанинова М.С., Меньщиков М.П., Вильмс Е.А. Гигиеническая характеристика изменений пищевого статуса взрослого населения Омской области в период реализации национального проекта «Демография» //Фундаментальная и клиническая медицина. 2024. Т. 9, № 3. C. 29-38.) doi: 10.23946/2500-0764-2024-9-3-29-38
Zhuk TV, Yavorskaya SD, Vostrikov VV. Predictors of IVF program failures in patients with infertility and excess body weight. Bulletin of Medical Science. 2017; 3(7): 58-55. Russian (Жук Т.В. Яворская С.Д., Востриков В.В. Предикторы неудач программ ЭКО у пациенток с бесплодием и профицитом массы тела //Бюллетень медицинской науки. 2017. № 3(7). С. 58-55)
Sahu A, Pajai S. The Impact of Obesity on Reproductive Health and Pregnancy Outcomes. Cureus. 2023; 15(11): e48882. doi: 10.7759/cureus.48882
Shabanova NS. Obesity in the Altai Territory. Scientist. 2020; 3(13): 20. Russian (Шабанова Н.С. Ожирение в Алтайском крае //Scientist. 2020. № 3(13). С. 20)
Artymuk NV, Novikova ON, Glazovskaya O.V. The state of health of children from mothers with gestational diabetes mellitus. Bulletin of Medical Science. 2023; 2(30): 11-14. Russian (Артымук Н.В., Новикова О.Н., Глазовская О.В. Состояние здоровья детей от матерей с гестационным сахарным диабетом //Бюллетень медицинской науки. 2023. № 2(30). С. 11-14.) doi: 10.31684/25418475-2023-2-11
Clinical protocol «Obesity». 2025. Russian (Клинический протокол «Ожирение». 2025 г.) URL: https://mirvracha.ru/clinicalrecommendations/full/ozhirenie (дата обращения: 28.03.2025)
Physiological pregnancy: clinical guidelines. Obstetrics and Gynecology: News, Opinions, Training. 2020; 8(4): 48-78. Russian (Нормальная беременность: клинические рекомендации //Акушерство и гинекология. Новости. Мнения. Обучение. 2020. Т. 8, № 4. С. 48-78)
Ob utverzhdenii poryadka okazaniya meditsinskoi pomoshchi po profilyu «akusherstvo i ginekologiya»: prikaz MZ RF ot 20.10.2020 g. № 1130n. Russian (Об утверждении порядка оказания медицинской помощи по профилю «акушерство и гинекология»: приказ МЗ РФ от 20.10.2020 г. № 1130н)
Medik VA, Tolmachev MS. Matematicheskaya statistika v medicine: uchebnoe posobie dlya srednego professional`nogo obrazovaniya v 2 t. T. 1. M., 2024. 471 s. Russian (Медик В.А., Толмачев М.С. Математическая статистика в медицине: учебное пособие для среднего профессионального образования в 2 т. Т. 1. М., 2024. 471 с.)
Valencia-Ortega J, Solis-Paredes JM, Saucedo R, Estrada-Gutierrez G, Camacho-Arroyo I. Excessive Pregestational Weight and Maternal Obstetric Complications: The Role of Adipokines. Int J Mol Sci. 2023; 24(19): 14678. doi: 10.3390/ijms241914678
Ismailova IV, Iztleuov EM. The effect of obesity on pregnancy. Obstetrics and Gynecology. 2020; 4S: 101-103. Russian (Исмаилова И.В., Изтлеуов Е.М. Влияние ожирения на течение беременности //Акушерство и гинекология. 2020. № 4S. С. 101-103)
Santos S, Voerman E, Amiano P, Barros H, Beilin LJ, Bergström A, et al. Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts. BJOG. 2019; 126(8): 984-995. doi: 10.1111/1471-0528.15661
Bone JN, Joseph KS, Magee LA, Muraca GM, Razaz N, Mayer C, Lisonkova S. Prepregnancy body mass index and adverse perinatal outcomes in the presence of other maternal risk factors. AJOG Glob Rep. 2023; 3(2): 100175. doi: 10.1016/j.xagr.2023.100175
Zheng Y, Dong X, Chen B, Dai J, Yang W, Ai J, Jin L. Body mass index is associated with miscarriage rate and perinatal outcomes in cycles with frozen-thawed single blastocyst transfer: a retrospective cohort study. BMC Pregnancy Childbirth. 2022; 22(1): 118. doi: 10.1186/s12884-022-04443-2
Kumar M, Mali KA. Study of maternal and fetal outcomes in obese women. Indian J Public Health. 2022; 66(4): 448-450. doi: 10.4103/ijph.ijph_1862_21
Tanner LD, Brock AC, Chauhan SP. Severity of fetal growth restriction stratified according to maternal obesity J Matern Fetal Neonatal Med. 2020; 35: 1886-1890. doi: 10.1080/14767058.2020.1773427
Dude AM, Davis B, Delaney K, Yee LM. Identifying fetal growth disorders using ultrasound in obese nulliparous women. J Matern Fetal Neonatal Med. 2021; 34(11): 1768-1773. doi: 10.1080/14767058.2019.1648420
Vel'kov VV. C-reactive protein is used in laboratory diagnostics of acute inflammations and in risk assessment of vascular pathologies. Clinical and laboratory consultation. 2008: 2(21): 37-48. Russian (Вельков В.В. С-реактивный белок в лабораторной диагностике острых воспалений и в оценке рисков сосудистых патологий //Клинико-лабораторный консилиум. 2008. № 2(21). С. 37-48)
Khalifa E, El-Sateh A, Zeeneldin M, Abdelghany AM, Hosni M, Abdallah A, et al. Effect of maternal BMI on labor outcomes in primigravida pregnant women. BMC Pregnancy Childbirth. 2021; 21(1): 753. doi: 10.1186/s12884-021-04236-z
Seregina DS, Nikolaenkov IP, Kuz'minyh TU. Obesity is the leading pathogenetic link in the pathological course of pregnancy and childbirth. Journal of obstetrics and womans diseases. 2020; 69(2): 73-82. Russian (Серегина Д.С., Николаенков И.П., Кузьминых Т.У. Ожирение – ведущее патогенетическое звено патологического течения беременности и родов //Журнал акушерства и женских болезней. 2020. Т. 69, № 2. С. 73-82.) doi: 10.17816/JOWD69273-82
Reed J, Case S, Rijhsinghani A. Maternal obesity: Perinatal implications. SAGE Open Med. 2023; 11: 20503121231176128. doi: 10.1177/20503121231176128