At term 365 (5.6%) of 6497 pregnant women weighed over 90 kg; in these obese patients there were significantly increased incidences of hypertension (43.6%), hyperglycemia (16.9%), and subnormal urinary estriol excretion (18.6%). Infants weighing 4000 g or more at birth were more than twice as common (20.5%) in this group of patients, but increased fetal size was not due to associated maternal hyperglycemia and did not lead to increased rates of operative delivery although obstructed labor occurred in 5 multiparas. The increased incidence of labor exceeding 24 hours after amniotomy (12.3%), primary postpartum hemorrhage (7.1%), neonatal asphyxia (14.0%), and puerperal pyrexia (9.6%) emphasizes the problems of management of labor in the obese parturient. Perinatal mortality was not increased and there was no maternal death. Obesity is not associated with less favorable maternal or perinatal results when prenatal care includes monitoring of glucose tolerance and fetoplacental function and when cephalopelvic disproportion is considered in every labor.
(C) 1981 The American College of Obstetricians and Gynecologists