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Abstract
Obesity is considered to be the most frequent clinical risk factor during pregnancy. Being obese carry a high risk for the pregnant females as it is associated with many risk factors such as hypertension, diabetes mellitus, macrosomia and obstructed labour. All these complications can cause many hazards to mother, fetus or both.
Gestational diabetes mellitus is diabetes that first appears after the 20th weeks of gestation and may result in many maternal and fetal complications.
The aim of this work was to study the relation between maternal obesity and the incidence of gestational diabetes mellitus and the role of serum leptin level was also evaluated.
The present study was conducted on one hundred and twenty five pregnant women attending the antenatal care unit at El Shatby Maternity University Hospital. All cases were primigravidae and their age ranged from 20 to 30 years old. They were included at 20 weeks of gestation and followed up till delivery. Cases were enrolled according to the WHO classification of body mass index (BMI) into five equal groups (each n=25) (2):
Group A: normal BMI (18.5 - 24.9).
Group B: pre obese (25.0 - 29.9).
Group C: obese class I (30.0 - 34.9).
Group D: obese class II (35.0 - 39.9).
Group E: obese class III (40.0).
All the five groups were subjected to the following:
1. Complete history taking as regard last menstrual period, weight, height and history of any medical diseases.
2. Clinical examinations which included general examination and BMI calculation from the equation (2):
BMI=
3. Ultrasound examination to detect fetal viability, gestational age, fetal weight and to exclude multiple pregnancies.
4. Laboratory investigation including O’sullivan’s test, 3-hours oral glucose tolerance test at 20, 28 and 37 weeks of gestation and serum leptin level at 20 and 37 weeks of gestation.
5. Follow up of these cases was done until delivery. At delivery the length of gestation, the mode of delivery and fetal birth weight were assessed.