THE COURSE OF PREGNANCY AND LABOR AND HEMOSTATIC PARAMETERS IN OVERWEIGHT AND OBESE WOMEN

Objective. To evaluate the impact of overweight and obesity on hemostasis and the course of pregnancy and labor. Subjects and methods. 248, 134, and 118 normal weight, overweight, and obese pregnant women, respectively, were examined. Clinical and statistical methods were used; coagulative, thrombocytic, and fibrinolytic hemostases were studied over time by trimesters. Results. In obese and overweight women, pregnancy was significantly more frequently complicated by gestosis, chronic placental insufficiency, and premature labor. The neonates from the mothers in these groups had lower weight and height values than those from normal weight women. The most pronounced thrombogenic shifts in coagulative and fibrinolytic hemostases were observed in obese and overweight pregnant women in the first and second trimesters, respectively. Body mass index, a history of premature labor, concomitant gestosis, and fibrinogen levels during the second trimester are the most important factors independently associated with premature birth. Conclusion. Prepregnancy body mass index (Quetelet index) should be borne in mind in pregnant women to identify overweight and obesity groups. The women in these groups are in need for hemostasis monitoring to assess a thrombotic risk and to elaborate an antithrombotic correction program. Body mass index, a history of premature labor, gestosis, and fibrinogen levels during the second trimester should be taken into account when predicting the risk of preterm birth.

overweight, obesity, pregnancy, hemostatic parameters