FETOMATERNAL OUTCOME IN OBESE PREGNANT WOMEN WITH PREGNANCY INDUCED HYPERTENSION VISITING CMH BAHAWALPUR

Abstract

Background: Both Maternal obesity and pregnancy-induced hypertension (PIH) are each major sponsors to maternal and perinatal adverse outcomes. Local figures on their collective effect in south Punjab are limited.

Objective: To determine the fetomaternal outcomes in obese pregnant women with PIH, and to observe whether these results vary by maternal age, gestational age, parity, (BMI) class and education.

Methods: This cross-sectional observational study conducted in the Department of Obstetrics and Gynecology, CMH Bahawalpur, from 6 March to 6 June 2025. Using non-probability convenience sampling, 273 obese women aged 15–45 years with a singleton pregnancy and PIH (gestational hypertension or preeclampsia) were enrolled. Women with pre-existing hypertension, systemic comorbidities, seizure history or a uterine scar were omitted. Maternal and fetal outcomes were documented and on a proforma and analyzed on SPSS v26 using the chi-square or Fisher's exact test (p ≤ 0.05).

Results: Gestational hypertension, preeclampsia and eclampsia reported to be 57.1%, 35.2% and 7.7% of cases. The caesarean section rate was 43.6%. Maternal complications included ICU admission (14.3%), postpartum hemorrhage (12.1%) and HELLP syndrome (5.1%). Preterm birth (26.0%), low birth weight (20.1%) and NICU admission (32.6%) were prevalent, and perinatal death happened in 2.2%. Only gestational age at enrollment was significantly associated with an outcome: HELLP syndrome was more frequent in women enrolled before 28 weeks (7.8%) or at 34 weeks or later (10.0%) than in those enrolled at 28–33 weeks (1.5%; p = 0.026). Preterm birth tended to rise with BMI class (24.6% to 37.1%; p = 0.061), and eclampsia tended to be higher at age 36–45 years (18.5%; p = 0.053), but neither reached significance.

Conclusion: Obese women with PIH are a high-risk obstetric group with substantial maternal and neonatal morbidity, regardless of age, parity or education. They merit close, protocol-based surveillance, with particular attention to gestational timing and obesity severity.