الفهرس 
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Abstract
H
igh maternal body mass index (BMI) is associated with complications during pregnancy and delivery such as gestational diabetes, hypertensive disorders, perineal injuries and fetal macrosomia.
Over the last decades, overweight and obesity have become an increasing health problem in the world, including Egypt. In 2008, 51.1% of the women ≥20 years were overweight and 20.1% were obese, and according to adult obesity forecasts, these numbers will probably increase further.
The increasing prevalence of obesity is a major public health concern especially among women of reproductive age. This trend has a major impact on pregnancy outcomes, as has been widely reported.
Women are at greater risk of maternal-fetal complications than women with a normal body mass index (BMI). Obese women are known to be at risk of antenatal, intrapartum, postpartum and neonatal complications such as hypertensive disorders of pregnancy, gestational diabetes mellitus, venous thromboembolism, cesarean section, preterm delivery, fetal macrosomia and unexplained stillbirths. Additionally, children born to obese mothers are at increased risk of obesity and metabolic disease and of developing neuropsychiatric and cognitive disorders.
In this study, we aimed to assess the effect of BMI on mode of delivery and maternal and neonatal complications in nulliparous women.
During this study, 370 patients were assessed for eligibility and 330 nulliparous pregnant women were included in the study and categorized into six different BMI (kg/m2) groups (55 in each group). Of all eligible patients, 22 patients were excluded from the study based on the inclusion criteria and 18 patients refused to participate in the study.
Ultimately, the analysis was based on the data of 330 nulliparous pregnant women that categorized into six different BMI (kg/m2) groups (55 in each group).
The current study revealed that there were no statistically significant differences between the studied groups regarding maternal age (18-35 years) and neonatal gestational age (37-40 weeks).
Regarding mode of delivery, our study results revealed that Cesarean delivery frequency was least frequent in underweight group then increases progressively to be most frequent in morbid obese group, the differences statistically were significant.
Regarding progression of normal labor, our results revealed that Duration of 1st stage and 2nd stage of labor were shortest in underweight group then increases progressively to be longest in morbid obese group, the differences statistically were significant.
Regarding fetal outcomes, our results revealed that Neonatal weight was significantly lowest in underweight group then increases gradually to be significantly highest in morbid obese group with no statistically significant differences as regard APGAR score at 1-min and 5-min between the studied groups.
Consequently, there were no statistically significant differences as regard Neonatal ICU admission frequency between the studied groups.
We concluded that an increased maternal pre-pregnancy BMI is an important and independent risk factor for delivery by cesarean section. A significant difference was observed in risk of cesarean between women with BMI ≥30 and women with normal weight in all subgroups of women with significant prolongation in 1st stage and 2nd stage of labor.
Neonatal weight was significantly lowest in underweight group then increases gradually to be significantly highest in morbid obese group.
Maternal overweight and obesity in pregnancy are important contributors to obstetric complications and adverse outcomes, with an associated significant impact on healthcare burden.
We recommend that Effective interventions to reduce the prevalence of overweight and obesity in pregnant women could have significant beneficial effects on pregnancy outcomes. Public health efforts are urgently required to promote weight management among women of reproductive age before conception and during pregnancy.