n South African Journal of Obstetrics and Gynaecology - Pregnancy outcomes in super-obese women - an even bigger problem? A prospective cohort study : research

Volume 20, Issue 2
  • ISSN : 0038-2329
  • E-ISSN: 2078-5135



To investigate whether differences exist in adverse pregnancy outcomes between morbidly obese (body mass index (BMI, kg/m2) 40 - 49.9) and super-obese women (BMI ≤50).

A prospective cohort study was undertaken at Tygerberg Hospital, a referral centre in the Western Cape Province of South Africa, of morbidly obese and super-obese pregnant women recruited from the antenatal clinic. Data were collected from the files 6 weeks after delivery. Primary outcomes included hypertension, diabetes mellitus and fetal macrosomia. Secondary outcomes included baseline characteristics, previous complications, antenatal and peripartum complications, and short-term neonatal outcomes.
Sixty-six morbidly obese and 46 super-obese women were enrolled. Super-obese women experienced significantly higher incidences of pre-eclampsia (24% v. 9%; =0.03) and interuterine growth restriction (13% v. 2%; =0.02) than morbidly obese women, and both groups had a high incidence of gestational diabetes (24% v. 24%; non-significant (NS)). Both super-obese and morbidly obese women experienced high rates of caesarean section (54% v. 41%; NS). In super-obese women these procedures lasted longer (50 v. 41 minutes; <0.01) and there were more surgical complications (36% v. 7%; =0.01). Prolonged admission (>3 days) after delivery was also more common in super-obese women (65% v. 42%; =0.03).
Super-obese women encounter more major pregnancy complications (especially hypertensive, pre-eclamptic and surgical) than morbidly obese women, emphasising the fact that these women should be managed at institutions with sufficient expertise.

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