Materno-foetal outcome of labour in obese women in Yaounde, Cameroon.
AbstractOverweight, obesity or morbid obesity has been shown to have a deleterious effect on the mother and the foetus. Among the various complications are macrosomic babies, increased caesarean section rate, postpartum haemorrhage, foetal distress and foetal death. The objectives of the study were to determine the socio-demographic characteristics of pregnant women with obesity and morbid obesity determine the mean birth weight, foetal length and Apgar score of the babies as well as associated maternal complications. This was a descriptive cross sectional prospective study carried out between the 1st of January and the
31st July 2006. Recruitment was carried out in the maternity service of the main teaching hospitals in Yaoundé. All pregnant women in labour or in the immediate postpartum with body mass index greater or equal to 30 were fit for the study. About half of the women were married (46.5%), multi-parous (49%), attained the level of secondary education (59:3%). Most of the women were of low socio-economic status (82%) with the male partners slightly more financially fit than the women (57.1%). The 25-29
years age group was most represented (32.6%), with the morbid obesity being preponderant (90.8%). Maternal complications were seen in 64% of the patients. The complications were more frequent in the morbid obesity than in the obesity group. Only uterine atony and placenta retention were seen in the obesity group. Placenta retention and caesarean section (20.5%) was commoner in the morbid obesity group. Stillbirths, small-for-dates, poor Apgar score and foetal macrosomia were reported in
the morbid obesity group. The babies were longer and weighed more with means of 51.3 cm and 3348 g respectively. Obesity and morbid obesity constitute a high risk factor in pregnancy. Pregnancy in these women must therefore be monitored closely in the ante-partum, intra-partum and immediate post-partum periods. Early detection of complications and treatment is paramount if we have to improve on the materno-foetal morbidity and mortality among obese pregnant women.