OBESITY IN PREGNANCY - A RISK FOR THE MOT HER AND HER OFFSPRING

Overweight is one of the most formidable health problems in Germany. T herefore, the risk factor ''obesity'' is gaining importance in pregnan t women. The investigation presented here deals with the influence of maternal weight on the course of pregnancy, delivery, post partum peri od and the condition of the newborn. 6747 deliveries at the Department of Obstetrics and Gynecology, Technical University of Munich, were ev aluated (1987-1993). Four groups were defined according to body mass i ndex (BMI, calculated as maternal pre-pregnancy weight divided by the square of maternal length): BMI 1 - subnormal weight (19.2%), BMI 2-no rmal weight (67.8%), BMI 3 - obese (8.2%) and BMI 4 extremely obese wo men (4.8%). Statistical evaluation was performed by comparison of the parameters of normal-weight and adipose women with the H-test (Kruskal and Wallis), Mann-Whitney-U- and X-2-test. Hypertension, proteinuria, placental insufficiency, and gestational diabetes were more common in obese women. The rate of spontaneous Vaginal deliveries was significa ntly lower in adipose women, and additionally they experienced more bi rth injuries. Non-elective Caesarean section rate was significantly hi gher in class BMI 4-women. Macrosomia, birth-related injuries (BMI 3), and the need for ventilation (BMI 4) were found more often in newborn of obese women. Prenatal care of adipose women deserves special atten tion. Prevention of obstetric problems associated with adiposity can o nly be achieved by weight reduction before conception.