The Feresu Research and Training Institute, Zimbabwe
Shinga Feresu is a Professor of Epidemiology and Biostatistics, completed her PhD in Epidemiology from The University of Michigan in 2001, USA, and Master of Public Health (MPH) in Epidemiology and Biostatistics from Boston University, USA in 1995. She obtained her postgraduate degree in Nursing (Community Health Nursing Science and Nursing Education) from the University of South Africa (UNISA) in 1989. She has taught at The University of Michigan, is Contributing Faculty at Walden University, USA. Since 2010; taught at The University of Nebraska Medical Center, USA, and Indiana University School of Public Health, Bloomington USA, before migrating to South Africa November 2014. She was an Associate Professor of Epidemiology and Biostatistics at the University of Pretoria until June 2018. She is an Online Module Developer, and Instructor at the University of Johannesburg, and is an Adjunct Professor at the University of Fort Hare (SA). Prof Feresu has published more than 25 papers in reputed journals and has been a peer reviewer from more than 25 journals. Prof Feresu has supervised more than 50 students in her career.
Background: Obesity is a serious medical condition affecting more than 30 % of Indiana, and 25 % of Unites States pregnant women. Obesity is related to maternal complications and significantly impacts the health of pregnant women.
Objective: The objective of this study was to describe the relationship between maternal complications and pre-pregnancy maternal weight.
Methods: Using logistic regression models, we analyzed 2008 to 2010 birth certificate data, for 255,773 live births abstracted from the Indiana Vital Statistics registry. We examined the risk of reproductive factors, obstetrical complications and perinatal (intrapartum) complications for underweight, healthy weight, overweight and obese women for this population.
Results: Women who received prenatal care were more likely to be obese [Adjusted Odds Ratio (AOR)=1.82 (1.56–2.13)], women with parity of zero (0) were less likely to be obese [AOR=0.89, 95% CI (0.86–0.91)]. Women giving birth to twins [AOR=1.25, 95% CI (1.17-1.33)], women delivering by Caesarean section [AOR=2.31, 95% CI (2.26–2.37)] and women who previously had a Caesarean section [AOR=1.95, 95% CI (1.88–2.02)] were more likely to be obese. Obesity was significantly associated with obstetrical conditions of the metabolic syndrome, including pre-pregnancy diabetes, gestational diabetes, pre-pregnancy hypertension, pregnancy-induced hypertension and eclampsia [AOR=5.12, 95% CI (4.47–5.85); AOR=3.87, 95% CI (3.68–4.08); AOR=7.66, 95% CI (6.77–8.65); AOR=3.23, 95% CI (3.07–3.39) and AOR=1.77, 95% CI (1.31–2.40), respectively. Maternal obesity modestly increased the risk of induction, epidural, post-delivery bleeding and prolonged labor [AOR=1.26, 95% CI (1.23–1.29); AOR=1.15, 95% CI (1.13–1.18); AOR=1.20, 95% CI (1.12–1.28) and AOR=1.44, 95% CI (1.30–1.61)], respectively.
Conclusions: Our results suggest that maternal obesity in Indiana, like other populations in the USA, is associated with high risks of maternal complications for pregnant women. Pre-pregnancy obesity prevention efforts should focus on targeting children, adolescent and young women, if the goal to reduce the risk of maternal complications related to obesity, is to be reached.