title: Retrospective cohort study of the effects of obesity in early pregnancy on maternal weight gain and obstetric outcomes in an obstetric population in Africa.
abstract: OBJECTIVE
  The purpose of this study was to compare maternal weight gain in pregnancy and obstetric outcomes between women with obesity in early pregnancy and those with a normal body mass index (BMI) in early pregnancy.
  
  
  METHODS
  This was a retrospective cohort study of women with obesity in early pregnancy and those with a normal BMI who were seen at three teaching hospitals in South-East Nigeria. Statistical analysis was performed using Statistical Package for the Social Sciences version 17.0 software, with descriptive and inferential statistics at the 95% level of confidence.
  
  
  RESULTS
  The study sample consisted of 648 women (324 obese and 324 healthy-weight). The mean age of the obese women was 26.7 ± 5.1 years and that of the healthy-weight women was 26.6 ± 4.9 years. Although both excessive weight gain (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.23-0.54) and inadequate weight gain (OR 0.08, 95% CI 0.04-0.15) were less common in women with early pregnancy obesity than in healthy-weight women, a significantly higher proportion of obese women with excessive weight gain had adverse fetomaternal outcomes. Also, a significantly higher proportion of obese women had specific complications, such as premature rupture of membranes (OR 2.36, 95% CI 1.12-5.04), gestational hypertension/pre-eclampsia (OR 2.31, 95% CI 1.12-5.04), antepartum hemorrhage (OR 2.78, 95% CI 1.02-7.93), gestational diabetes (OR 4.24, 95% CI 1.62-11.74), cesarean delivery (OR 2.3, 95% CI 1.2-5.44), macrosomia (OR 4.08, 95% CI 1.06-8.41), severe birth asphyxia (OR 2.8, 95% CI 1.2-6.63), abnormal Apgar scores (OR 2.67, 95% CI 1.46-4.93), and newborn special care admissions (OR 1.18, 95% CI 1.0-3.29).
  
  
  CONCLUSIONS
  Early pregnancy obesity was associated with a wide range of adverse fetomaternal outcomes, and could be a genuine risk factor for increased pregnancy-related morbidity and/or mortality in this population. Interventions to reduce prepregnancy obesity could therefore be useful in this low-resource African setting.
authors: Departments of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors: Chukwuemeka A
authors: CA
authors: Iyoke
authors: George O
authors: GO
authors: Ugwu
authors: Frank O
authors: FO
authors: Ezugwu
authors: Osaheni L
authors: OL
authors: Lawani
authors: Azubuike K
authors: AK
authors: Onyebuchi
keywords: early pregnancy; maternal weight gain; obesity; obstetric outcomes
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