Obstetric management of obesity in pregnancy

Rates of obesity among the pregnant population have increased substantially and adiposity has a damaging effect on every aspect of female reproductive life. This review summarises epidemiological data concerning obesity-related complications of pregnancy. Obesity is linked to a number of adverse obstetric outcomes as well as increased maternal and neonatal morbidity and mortality. These complications include miscarriage, congenital abnormalities, pre-eclampsia, gestational diabetes mellitus, iatrogenic preterm delivery, postdates pregnancy with increased rates of induction of labour, caesarean section, postpartum haemorrhage, shoulder dystocia, infection, venous thromboembolism, and increased hospital stay. It is important to consider obese pregnant women as a high risk group with a linear increase in risk of complications associated with their degree of obesity. Their obstetric management should be consultant-led and involve a multidisciplinary team approach to improve outcome. (C) 2009 Elsevier Ltd. All rights reserved.