Obesity and related pregnancy complications in an inner-city clinic

OBJECTIVE: The study was designed to determine the prevalence of obesity and related pregnancy complications in an inner-city prenatal clinic.STUDY DESIGN:A retrospective review was conducted of the medical records of 281 women with no chronic diseases and who delivered singleton term babies during a 1-year period. The frequencies of various pregnancy complications, including pregnancy-induced hypertension, preeclampsia, gestational diabetes, shoulder dystocia, postpartum hemorrhage, fourth degree laceration, intrauterine growth restriction, and macrosomia, were compared among groups of patients stratified by body mass index (BMI).RESULTS:Thirty-four percent of patients had a reported prepregnancy BMI of >26 kg/m2. Fifty-two percent of patients were obese (BMI > 26 kg/m2) when they registered for prenatal care, and 82% of patients had a BMI > 26 kg/m2 at the time of delivery. The incidence of birth weights of >4 kg was significantly higher in women with a registration BMI > 26 kg/m2 (p = 0.026). Most of these macrosomic babies had mothers with a BMI > 29 kg/m2. Patients who required cesarean delivery had significantly higher BMI than those who were delivered vaginally (p < 0.001).CONCLUSION:Obesity was more common in our inner-city population than has previously been reported and was associated with an increased risk of fetal macrosomia and operative delivery. © 1999 Stockton Press. All rights reserved.