title: The Effect of Obesity on Pregnancy and its Outcome in the Population of Oman, Seeb Province.
abstract: OBJECTIVE
  The World Health Organization estimated that in 2011 worldwide 1.6 billion adults were overweight, and 400 million were obese. The obesity epidemic is a documented phenomenon and Oman is no exception. The aim of this study was to determine the effect of obesity on pregnancy and its prenatal and neonatal outcomes.
  
  
  METHODS
  A prospective cohort study was carried out among pregnant Omani women attending antenatal clinics in their first trimester in the Seeb province of Muscat, Oman.
  
  
  RESULTS
  A total of 700 pregnant women were enrolled in the study and were categorized according to their body mass index: 245 (35%) were normal weight, 217 (31%) were overweight, and 238 (34%) were obese. The relative risk (RR) of cesarean section among obese women compared to women of normal weight was 2.1 (95% confidence interval (CI) 1.2-3.2) and of overweight women was 1.4 (95% CI 0.9-2.3). The risk of elective cesarean section increased to 7.5 (95% CI 1.7-32.8) in obese women and was statistically significant in the obese group. In this study, 100 women (15.7%) developed gestational diabetes (11.8% of normal weight women, 17.8% of overweight women, and 17.9% of obese women). Miscarriages were more common among obese women 11.9% (n = 27) compared to the normal weight and overweight groups (6.7% and 9.4%, respectively). There was a weak yet statistically significant correlation between birth weight and body mass index. The risk of macrosomia was significantly higher in obese women compared to normal weight women. To evaluate the sensitivity of the oral glucose challenge test (OGCT), the oral glucose tolerance test (OGTT) was measured in 203 participants (29%) who had a normal OGCT result. It was found that 14.5% of overweight women and 13.5% of normal weight women had an abnormal OGTT result even when their OGCT result was normal.
  
  
  CONCLUSIONS
  Obesity is associated with an increased risk of cesarean section (especially elective cesarean), gestational hypertension, macrosomia, and miscarriage. It also increases the risk of gestational diabetes.
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Fatma M
authors.initials: FM
authors.lastname: Al-Hakmani
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Faiza A
authors.initials: FA
authors.lastname: Al-Fadhil
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Lamia H
authors.initials: LH
authors.lastname: Al-Balushi
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Norah A
authors.initials: NA
authors.lastname: Al-Harthy
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Zakiya A
authors.initials: ZA
authors.lastname: Al-Bahri
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Naama A
authors.initials: NA
authors.lastname: Al-Rawahi
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Manal S
authors.initials: MS
authors.lastname: Al-Dhanki
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Imrana
authors.initials: I
authors.lastname: Masoud
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Nahal
authors.initials: N
authors.lastname: Afifi
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Aisha
authors.initials: A
authors.lastname: Al-Alawi
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Harikumar
authors.initials: H
authors.lastname: Padmakumar
authors.affiliation: Directorate General of Health Services, Governorate of Muscat, Ministry of Health, Oman.
authors.forename: Padmamohan J
authors.initials: PJ
authors.lastname: Kurup
keywords: Abortion Rate; Cesarean Section; Diabetes, Gestational; Fetal Macrosomia; Glucose Tolerance Test; Hypertension, Pregnancy-Induced; Obesity; Pregnancy
references.citation: Obes Rev. 2010 Jan;11(1):31-40
references.pmid: 19413707
references.citation: BMC Pregnancy Childbirth. 2010 Sep 17;10:56
references.pmid: 20849609
references.citation: Int J Obes Relat Metab Disord. 2001 Aug;25(8):1175-82
references.pmid: 11477502
references.citation: J Hypertens. 2011 May;29(5):937-44
references.pmid: 21430559
references.citation: Ann Saudi Med. 2010 Sep-Oct;30(5):376-80
references.pmid: 20697173
references.citation: J Obstet Gynaecol Can. 2009 Jan;31(1):28-35
references.pmid: 19208280
references.citation: Obes Rev. 2007 Sep;8(5):467-73
references.pmid: 17716304
references.citation: J Obstet Gynaecol Can. 2013 Mar;35(3):224-33
references.pmid: 23470110
references.citation: Obstet Gynecol. 2007 Oct;110(4):752-8
references.pmid: 17906005
references.citation: Obes Rev. 2009 Jan;10(1):28-35
references.pmid: 19021871
references.citation: Am J Perinatol. 2010 Apr;27(4):333-8
references.pmid: 20013581
references.citation: Rev Saude Publica. 2006 Jun;40(3):457-65
references.pmid: 16810370
references.citation: Lancet. 2013 Feb 9;381(9865):476-83
references.pmid: 23290494
references.citation: Semin Reprod Med. 2011 Nov;29(6):507-13
references.pmid: 22161463
references.citation: Saudi Med J. 2004 Mar;25(3):346-51
references.pmid: 15048174
references.citation: Fertil Steril. 2008 Sep;90(3):714-26
references.pmid: 18068166
references.citation: Med J Aust. 2010 Mar 1;192(5):260-4
references.pmid: 20201759