Introduction: Obesity is associated with specific increased perinatal risks to mother and child. The study sets out to identify and assess the risk in a high NIDDM prevalence population. Methodology: The obstetric outcomes of 1691 women with a body weight ≥ 85 kg and a pre-pregnancy BMI >30 and their 1721 infants were statistically compared to similar parameters in the background population of 18717 maternities and 18974 births. Results: Obese mothers were characteristically more likely to be older than 30 years of age [p<0.0001], multiparous [p<0.0001] with a history of previous miscarriages [p=0.003]. The antenatal period was more likely to be complicated by hypertensive disease [pre-existing and pregnancyinduced; p<0.0001], and gestational diabetes [p<0.0001]. They were less likely to suffer from accidental haemorrhage [p=0.0074]. These antenatal problems were not simply a determinant of maternal age. They did not appear to have a significantly higher risk of pre-existing diabetes [p=0.3267] and did not require an increased risk of assisted reproduction [p=0.3953]. The multiple pregnancy rates were also not statistically increased [p=0.3121]. The obese women were also more likely to require obstetric interventions with induction of labour [p<0.0001] and Caesarean section [p<0.0001]. There was a statistically lower rate of operative deliveries [p=0.0007]. The preterm delivery rates were not different [p=0.947] between the two groups of women. The infants born to obese women were at a statistically higher risk for macrosomia [more than 4.0 kg; p<0.0001] and lower risk for low birth weight [under 2.5 kg; p=0.0248]. They also had a statistically higher risk for congenital malformations. There was a slightly higher risk for respiratory distress although the differences did not reach statistical significance [p=0.0596]. There was not any significantly increased risk for perinatal loss [p=0.8212], shoulder dystocia [p=0.5059], and low APGAR scores at five minutes [p=0.9989]. There were no differences in the male: female ratios [p=0.761]. Infants born to obese women were less likely to be solely breastfeed, though the differences did not reach statistical significance [p=0.0782]. Conclusion: It appears that the obese pregnant woman and her infant are predisposed to adverse short-term obstetric outcomes similar to those found in gestational diabetics. This relationship may reflect determinants of the “Metabolic Syndrome”. (Int J Diabetes Metab 14: 88-91, 2006 )

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