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Objectives

Methods

Results

Conclusions

References

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1S KHALID, 1M MASRI, 1SHAMSIR ARIS, 2M GANESALINGAM 1Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia.

2Department of Obstetrics Gynaecology, Hospital Ampang, Malaysia.

A six month retrospective study was conducted in Hospital Ampang from 1st March until 31st August 2011. From a total of 3797 deliveries, only 911(23.99%) of patients had their weight and BMI documented in their notes during their first trimester. Patients who had their booking done during second or third trimester or those without their BMI documented at first trimester were excluded from this study. Patient’s BMI were then categorized according to three major BMI group which are BMI < 25, BMI 25-30 and BMI > 30. The maternal outcome which include mode of delivery, estimated blood loss and other complications were then identified. NICU admissions were also documented as the fetal outcome.

Results

From 911 cases, 579 (64.15%) had BMI of <25, 205 (22.5%) had BMI of 25-30 and 127 (13.94%) had BMI of > 30 (Figure 1).

The percentage of spontaneous vaginal delivery dropped from 75.13% (435/579) among patients with BMI of <25 to 70.24% (144/205) among patients with BMI of 25-30 and to 62.99% (80/127) among patients with BMI >30 (Figure 2).

The number of lower segment caesarean section (LSCS) increases from 19.17% (111/579) to 25.37% (52/205) and to 33.86% (43/127) by which 13.99% (81/579), 18.05% (37/205) and 24.41% (31/127) were emergency LSCS in BMI group of <25, 25-30 and >30 respectively (Figure 3).

Patients need to be well informed that being overweight or obese during pregnancy will have a higher risk of adverse maternal and fetal outcome compared to those with a normal BMI. The importance of achieving a normal BMI prior to getting pregnancy is crucial in order to minimize such risk.

THE OUTCOME OF OVERWEIGHT AND OBESITY IN PREGNANCY: A 6 MONTHS RETROSPECTIVE STUDY IN HOSPITAL AMPANG, MALAYSIA.

To determine the prevalence of overweight and obesity among pregnant women in Hospital Ampang and it associated maternal and fetal outcomes.

Estimated blood loss (EBL) of > 500mls also increases from 2.59% (15/579) among patients with BMI of <25 to 6.83% (14/205) among patients with BMI of 25-30 and 14.17% (18/127) in patients with BMI of >30. Similar trend was seen in NICU admission with the highest NICU admission among patients with BMI of >30 with 26.77% (34/127) of deliveries require NICU admission followed by 23.41% (48/205) among patients with BMI of 25-30 and 19% (110/579) among those of BMI of <25.

Background

There is an increasing prevalence of maternal overweight and obesity in many countries (1). Many studies have shown adverse outcomes associated with overweight and obesity (2-3).

1. Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989– 2007. Int J Obes 2009;34:420–8.

2. Yu CKH, Teoh TG, Robinson S. Obesity in pregnancy. BJOG 2006;113:1117–25.

3. Andreasen KR, Andersen ML, Schantz AL. Obesity and pregnancy. Acta Obstet Gynecol Scand 2004;83:1022–9.

Figure 3 Percentage of LSCS and EMLSCS according to each BMI group

Interesting to note that the number of assisted delivery was documented the most among patients with BMI of <25 with 5.7% (33/579) followed by BMI of 25-30 with 4.39% (9/205) and 3.15% (4/127) in patients of BMI >30.