The Management of Obese Women in Pregnancy & Neonatal Outcome in Malta

Background: Over the past few years, the rise of obesity in pregnancy has been associated with a rise in pregnancy complications. The aim of this audit was to analyze the current management of obese women in pregnancy at Mater Dei Hospital (MDH). The Royal College of Obstetricians and Gynaecologists (RCOG) green-top guideline: Care of Women with Obesity in Pregnancy which was published in 2018 was used as a standard for this audit. Method: Data was collected from inpatient medical notes of obese mothers who presented at MDH between July 2020 and October 2020. There was no patient contact during data collection and all data was kept anonymous. Results: 53 mothers were recorded as obese between July and October 2020. The average maternal age was 31 years and the average maternal weight was 94kgs at antenatal booking visit. 47% of obese mothers were classified as Class 1 obese. Only 38% of obese mothers had an oral glucose test performed, and 70% of these mothers had a positive test.54.7% delivered via a caesarean section. 12% of neonates required NPICU admission. Conclusion: Pregnancy in women with obesity is an important public health problem with short- and long-term implications for maternal and child health. This audit demonstrates that the management of obese women in pregnancy currently in use at MDH does not follow all the RCOG recommendations. We suggest the need for local guidelines together with the use of patient information leaflets to help improve the care of women with obesity in pregnancy.