Maternal and perinatal outcomes among obese parturients in the Riga Maternity Hospital

The increasing number of obese women of reproductive age leads to the global epidemic of obesity. In 2018 in Latvia 16.4% of women between age 15 and 49 were obese. Adipose tissue has dysregulatory effects on metabolic, vascular, and inflammatory pathways in many organ systems during pregnancy. Obese pregnant women are at increased risk for an array of maternal and perinatal complications. All pregnant women with obesity (maternal pre-pregnancy BMI ≥30 kg/m2) who delivered in the Riga Maternity Hospital in Riga, Latvia from January 2018 to December 2019 were included in a retrospective case-control study. We used individual participant data from 684 mother-offspring pairs and assessed the associations of obesity and maternal and perinatal outcomes. As control group 242 mothers with normal BMI were selected. In 2018 and 2019, there were 11776 deliveries in the Riga Maternity Hospital. Obesity was identified in 684 (5.8%) of women. Total rate of Cesarean sections was 223 (32.6%) in the case group and 39 (16.2%) in the control group. The diagnosis of preeclampsia, gestational hypertension and gestational diabetes mellitus was made in 25 (3.7%), 118 (17.3%) and 175 (25.6%) in cases and in 4 (1.6%), 9 (3.7%) and 12 (5.0%) in controls, respectively. Preterm birth was in 69 (10.1%) in the case group and in 20 (8.3%) in the control group. Macrosomia (birth weight >4000 g) was identified in 182 (26.0%) neonates and 46 (19.0%) neonates in obese mothers and normal BMI mothers, respectively. Admission in neonatal ICU was needed for 80 (11.4%) newborns in cases and 15 (6.2%) in controls. Obesity during pregnancy enhances maternal and fetal vulnerability to different adverse short-term and long-term obstetric outcomes. There is a need for a great focus and comprehensive approach on preventing, screening, diagnosing, and managing obesity-related problems in pre-pregnancy period and pregnancy.