The impact of obesity on outcome of delivery : - A retrospective observational study in a Swedish obstetric population

Abstract: Introduction: Pre-pregnancy obesity was prevalent among 18% of women who delivered in Örebro in 2017. The rate has increased and previous international studies have identified obesity as a major risk factor for poor reproductive health among women. Aim: To analyze the association between maternal pre-pregnancy obesity and major obstetrical outcomes within the Örebro region. Methods: This retrospective observational study collected data from 1st Jan. 2015 to 30th Jun. 2018 via the Swedish Pregnancy Register. All women, who delivered simplex deliveries in the Örebro region during the study period, were eligible for inclusion. Exclusion criteria were BMI <18.5 kg/m2, delivery by forceps, incomplete data and admission to antenatal care at >17 gestational weeks. Women were categorized into obese (BMI >30 kg/m2) or non-obese (BMI <29.9 kg/m2) and compared by several obstetrical outcomes. Results: Of the 6846 included women, 17.8% were classified as obese. Obese women had several adverse maternal obstetrical outcomes. They had a significantly increased risk of undergoing induction of labor (OR 1.85), cesarean delivery (CD) (OR 1.46), emergency CD (OR 1.38), repeated CD (OR 1.47), having longer cesarean duration, higher total blood loss, and higher fetal birthweight. Conclusions: Pre-pregnancy obesity, among women in the Örebro region, is associated with significantly increased risk of adverse maternal outcomes during delivery and intervention before, during and after delivery should be further studied in order to minimize risk of complications in this risk group.