The Impact of Maternal Weight on Pregnancy Complications among Primiparous Women: A Retrospective Study from a Tertiary Care Center

Abstract

Context: In the last three decades, there has been a consistent and concerning rise in obesity rates, with the current estimate surpassing 1 billion individuals. This escalating trend poses significant health challenges, particularly during pregnancy, where obesity is identified as a notable risk factor for various pregnancy-related conditions, including an increased likelihood of caesarean sections (CS). Objective: To determine if obesity is associated with pregnancy-related conditions and higher incidence of CS. Methods: A retrospective analysis of primiparous women who had given birth at hospital of Lithuanian University of Health Sciences Kauno klinikos in 2011 - 2012 and 2021 - 2022 was conducted. The incidence of body mass index (BMI), mode of delivery, episiotomies, intrauterine growth retardation (IUGR), fetal macrosomia, gestational diabetes, gestational hypertension and preeclampsia was analysed. Patients: A total of 5,470 primiparous women were included in the study. Interventions: none. Main outcome measures: prevalence of obesity, the overall CS rate, the CS rate among obese patients, the incidence of pregnancy-related conditions. Results: Among 5,470 primiparas, 429 women (7,84 %, BMI > 30 kg/m²) were identified as obese. In 2011 – 2012 the rate of obesity among primiparous women was significantly lower – 4,59 % compared to 11,23 % in 2021 – 2022 . A total of 1,681 CS (30,73 %) were performed. In both analysed time periods the CS rate was statistically significantly higher among obese patients (45,30 % in 2011-2012 and 35,90 % in 2021-2022, p < 0,01 and p = 0,015 respectively). Episiotomies were more frequently required for non-obese than obese patients (37,89 % and 30,30 % respectively, p = 0,002). Pregnancy associated hypertension was more prevalent among obese primiparas (31,70 % in obese vs 9,96 % in non-obese women, p < 0,001) as well as gestational diabetes (48,5 % in obese vs 16,7 % in non-obese patients, p < 0,001). There was no significant impact on IUGR, but fetal macrosomia was more frequent among obese patients (9,56 % in obese vs 4,36 % in non-obese women, p < 0,001). Conclusions: Our study revealed an increased incidence of obesity among primiparous women over the analysed decade. Obese patients exhibited a strong association with a higher CS rate, along with a heightened prevalence of pregnancyrelated hypertension, gestational diabetes, and fetal macrosomia