Obesity in Pregnant Women and Its Impact on Maternal and Neonatal Morbidity

Obesity in pregnancy is currently a health problem that is associated with increased maternal and neonatal morbidity. Along with the times and lifestyles that are more modern, the incidence of obesity is also increasing. Clinically, obesity is defined as the condition of having excess adipose tissue. Obesity is related to insulin resistance and chronic inflammation. This makes obesity a risk factor for various non-contagious diseases such as cardiovascular disease, hypertension, diabetes mellitus, and cancer. The health consequences of maternal obesity are based on low-grade, chronic (meta-inflammatory) inflammation that occurs as a result of changes in the immune system and proinflammatory cytokines in maternal obesity and pregnancy. Obesity can have a negative impact on maternal, neonatal and labor outcomes. Several maternal complications that can occur due to obesity (BMI 30-34.9) and morbid obesity (BMI ≥ 35) are hypertension during pregnancy (10.2-12.3%), preeclampsia (3-6.3%), gestational diabetes (6.3-9.5%). Risks that can occur to the fetus, such as the occurrence of macrosomia (15.4-17.2%), preterm birth (4-5.5%) and impaired fetal growth (1-0.8%). Maternal obesity is also associated with an increased risk of neural tube defects (NTD) in babies, as well as a higher risk of abortion (1.70-3.11%). Obesity also has an impact on the delivery process. Mothers with obesity have a higher rate of vaginal operative procedures (8.5-11.1%), labor induction and longer duration of labor. The increase in caesarean section deliveries is caused by the occurrence of complications due to maternal obesity, namely the occurrence of preeclampsia, fetal distress, macrosomia, and induction failure.