Outcome of deliveries in healthy but obese women: obesity and delivery outcome

A healthy group of 787 women with full-term pregnancies and spontaneous onset of labor were included in the study. Delivery outcome was assessed in relation to maternal BMI when attending the antenatal clinic.The results indicated that in deliveries where the maternal BMI was >30 a high frequency of abnormal CTG trace during the last 30 minutes of labor was shown. A blood sample for evaluation of risk of fetal hypoxia was performed in only eight percent of these deliveries. A spontaneous vaginal delivery without intervention was noted in 85.7%, and 12% of neonates were delivered with an adverse fetal outcome compared to 2.8% in the group with a maternal BMI<30 (p<0.001).These results indicate an increased risk at delivery for healthy, but obese women in labor. Furthermore, the delivery management may not always be optimal in these deliveries.Obesity in women of childbearing age is a growing global problem. In Sweden, information on maternal height and weight on registration for antenatal care has been recorded since 1992, and onwards Body Mass Index (BMI, calculated as weight in kilograms divided by height in meters squared (kg/m2)) has increased among both primiparas as well as multiparas. In 2008, almost 25% of all pregnant women in Sweden were shown to be overweight (BMI 25-29.9) on presentation at the antenatal clinic and almost 12% of them were considered as obese (BMI？≥？30) [1].It is well known that obesity is associated with increased maternal and fetal morbidity during pregnancy and labour [2-8]. Furthermore, obesity is also associated with increased risk of caesarean section [3,5-15]. A meta-analysis has estimated the risk of caesarean section to be doubled for obese women, and tripled for women with severe obesity (BMI？≥？35) [16]. An extended labour progress is associated with an increased risk of severe maternal and fetal outcome and has previously been shown to be overrepresented among women with obesity [17]. In addition, neonates born to obese mothers