The Effect of Obesity on Birth Stages and Examination of Perinatal Outcomes

Yıl 2023, Cilt: 7 Sayı: 1, 1 - 7, 28.04.2023

İsa Şükrü Öz , Özden Kutlay

https://doi.org/10.25048/tudod.1215507

Öz

Aim: It is to evaluate the perinatal outcomes of pregnant women diagnosed with obesity by following their prognosis and to examine
the effects of obesity on birth stages.
Material and Methods: The study group consisted of 90 pregnant women who were diagnosed with obesity and applied to the obstetrics
and gynecology clinic of our hospital between October 2021 and May 2022, and 90 pregnant women with normal weight constituted the
control group. The birth stages were divided into stage of delivery, Stage-1, Stage-2, Stage-3 and Stage-4 for both groups. Comparisons
between recorded parameters were made between groups. Mann Whitney test was used to compare the groups. Chi-square test was used
to compare categorical data. In statistical tests, p<0.05 was accepted as significant.
Results: In the obese group, Stage-2 was significantly prolonged (15-49 min) (p<0.001), while the latent phase was shortened (3.3-4.6
min) (p<0.001). It was observed that Stage-2 was significantly longer in those who had their first pregnancy (33-49 min) (p<0.001). In
obese patients with a second pregnancy, Stage-2 was found to be significantly longer (20-41 min) (p<0.001), while the active phase was
found to be short (4.1-4.6 hours) (p=0.012). In obese pregnants with their third pregnancy, Stage-2 was found to be significantly longer
(15-25 minutes) (p<0.001), while the active phase was found to be significantly short (4.1-4.5 hours) (p=0.003).
Conclusion: The 2nd stage of labor is longer in nulliparous and multiparous obese pregnant than in normal weight pregnants. In
addition, the active phase in the first stage of labor in multiparous patients is shorter in obese pregnants than in normal weight pregnants.
In general, the latent phase in the first stage of labor is shortened in obese pregnants compared to normal weight pregnants

Anahtar Kelimeler

Obesity, Perinatal outcomes, Stages of birth

Obezitenin Doğum Evreleri Üzerine Etkisi ve Perinatal Sonuçların İncelenmesi

Öz

Amaç: Bu çalışmada, obez gebelerin prognoz takibine göre perinatal sonuçlarının değerlendirilerek obezitenin doğum evreleri üzerine
olan etkilerinin incelenmesi amaçlandı.
Gereç ve Yöntemler: Çalışmaya Ekim 2021 ile Mayıs 2022 arası kadın hastalıkları ve doğum kliniğine başvuran obezite tanılı 90 gebe
çalışma grubunu, normal kilolu 90 gebe ise kontrol grubunu oluşturdu. Doğum evreleri her iki grup için Evre-1, Evre-2, Evre-3 ve Evre-
4 olarak ayrıldı. Kayıt altına alınan parametrelerin gruplar arasındaki karşılaştırılmasında Mann Whitney testi uygulandı. Kategorik
verilerin kıyaslanmasında Ki-kare testi yapıldı. İstatistiksel testlerde p<0,05 anlamlı olarak kabul edildi.
Bulgular: Obez grupta Evre-2 anlamlı şekilde uzarken (15-49 dk) (p<0,001) latent fazın kısaldığı saptandı(3.3-4.6 dk) (p<0,001). İlk
gebeliği olanlarda Evre-2’nin obez olanlarda anlamlı şekilde uzun olduğu görüldü (33-49 dk) (p<0,001). İkinci gebeliği olan obez
hastalarda Evre-2 anlamlı olarak uzun (20-41 dk) (p<0,001), aktif fazın ise kısa olduğu (4.1-4.6 saat)(p=0,012) tespit edildi. Üçüncü
gebeliği olan obez gebelerde Evre-2 anlamlı olarak uzun (15-25 dk) (p<0,001), aktif faz ise anlamlı olarak kısa bulundu (4.1-4.5 saat)
(p=0,003).
Sonuç: Doğumun ikinci evresi nullipar ve multipar obez gebelerde, normal kilolu gebelere göre uzundur. Ayrıca multipar hastalarda
doğumun birinci evresinde aktif faz obez gebelerde normal kilolu gebelere göre kısadır. Genel olarak ise doğumun birinci evresindeki
latent faz obez gebelerde normal kilolu gebelere göre kısalmıştır.

Anahtar Kelimeler

Obezite, perinatal sonuçlar, doğumun evreleri.

Kaynakça

• 1. Daşıkan Z. Gebelikte kilo alımı: Gebe kadınlar prenatal bakımda doğru kilo alım önerisi alıyor mu? J Gynecol Obst. 2015;5(1):32-38.
• 2. Davies GAL, Maxwell C, McLeod L. Obesity in pregnancy. J Obstet Gynaecol Can. 2010;32(2):165-173.
• 3. Mission JF, Marshall NE, Caughey AB. Pregnancy risks associated with obesity. Obstet Gynecol Clin North Am. 2015;42(2):335-353.
• 4. Singh S, Kohli UA, Vardhan S. Management of prolonged second stage of labor. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2018;7(7):2527- 2531.
• 5. Kara M, Üstün YE. Obezitenin kadınlarda fertilite ve gebelik üzerindeki etkileri. Bozok Tıp Dergisi. 2017;7(1):70-73.
• 6. Rocha ALL, Campos RR, Miranda MM, Raspante LB, Carneiro MM, Vieira CS, Reis FM. Safety of hormonal contraception for obese women. Expert Opinion on Drug Safety. 2017;16(12):1387-1393.
• 7. Özcan A, Töz E, Özvatan SH, Vural T, Sancı M. Obez gebeliklerin yönetimi. Tepecik Eğitim ve Araştırma Hastanesi Dergisi. 2016);26(1):1- 9.
• 8. Ge X, Tao F, Huang K, Mao L, Huang S, Niu Y, Hao J, Sun Y, Rutayisire E. Maternal snoring may predict adverse pregnancy outcomes: A cohort study in China. PLoS One. 2016;11(2):e0148732.
• 9. Melchor I, Burgos J, Del Campo A, Aiartzaguena A, Gutiérrez J, Melchor JC. Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: A historical cohort study. J Perinat Med. 2019;47(6):625-630.
• 10. Marchi J, Berg M, Dencker A, Olander EK, Begley C. Risks associated with obesity in pregnancy, for the mother and baby: A systematic review of reviews. Obesity Reviews. 2015;16(8):621-638.
• 11. Hajagos-Tóth J, Ducza E, Samavati R, Vari SG, Gaspar R. Obesity in pregnancy: A novel concept on the roles of adipokines in uterine contractility. Croat Med J. 2017;58(2):96- 106.
• 12. Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet. 2006;93(3):269-274.
• 13. Nuthalapaty FS, Rouse DJ, Owen J. The association of maternal weight with cesarean risk, labor duration, and cervical dilation rate during labor induction. Obstet Gynecol. 2004;103(3):452- 456.
• 14. Ahmed A, Delgado-Olguin P. Embryonic programming of heart disease in response to obesity during pregnancy. Biochim Biophys Acta Mol Basis Dis. 2020;1866(2):165402.
• 15. Ovesen P, Rasmussen S, Kesmodel U. Effect of prepregnancy maternal overweight and obesity on pregnancy outcome. Obstet Gynecol. 2011;118(2 Pt 1):305-312.
• 16. Gaudet L, Ferraro ZM, Wen SW, Walker M. Maternal obesity and occurrence of fetal macrosomia: A systematic review and meta-analysis. Biomed Res Int. 2014;2014:640291.
• 17. Kim SS, Zhu Y, Grantz KL, Hinkle SN, Chen Z, Wallace ME, Smarr MM, Epps NM, Mendola P. Obstetric and neonatal risks among obese women without chronic disease. Obstet Gynecol. 2016;128(1):104-112.
• 18. Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, Regan L, Robinson S. Maternal obesity and pregnancy outcome: A study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord. 2001;25(8):1175-1182.
• 19. Farah N, Maher N, Barry S, Kennelly M, Stuart B, Turner MJ. Maternal morbid obesity and obstetric outcomes. Obes Facts. 2009;2(6):352-354.
• 20. Vahratian A, Zhang J, Troendle JF, Savitz DA, Siega-Riz AM. Maternal prepregnancy overweight and obesity and the pattern of labor progression in term nulliparous women. Obstet Gynecol. 2004;104(5 Part 1):943-951.
• 21. Dinatale A, Ermito S, Fonti I, Giordano R, Cacciatore A, Romano M, La Rosa B. Obesity and fetal-maternal outcomes. J Prenat Med. 2010;4(1):5-8.
• 22. Mamun AA, Callaway LK, O’Callaghan MJ, Williams GM, Najman JM, Alati R, Clavarino A, Lawlor DA. Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay. BMC Pregnancy Childbirth. 2011;11:62.
• 23. Cnattingius S, Villamor E, Johansson S, Edstedt Bonamy AK, Persson M, Wikström AK, Granath F. Maternal obesity and risk of preterm delivery. JAMA. 2013;309(22):2362-2370.