Association Between Obesity and Adverse Obstetric Outcomes Among Parturients in Lagos Tertiary Hospitals

Maternal obesity is an established risk factor for a range of adverse obstetric outcomes, yet its quantitative impact on pregnancy complications in Lagos, where urbanisation and dietary transition have increased obesity prevalence, requires empirical characterisation. This study examines the association between pre-pregnancy and first-trimester obesity and adverse obstetric outcomes at Lagos University Teaching Hospital and Lagos State University Teaching Hospital. A retrospective cohort of 400 singleton pregnancy deliveries, including 200 obese women (BMI 30 kg/m2 or above at booking) and 200 normal-weight controls, was assembled from delivery records. Primary outcomes included gestational diabetes mellitus, preeclampsia, emergency caesarean section, postpartum haemorrhage, wound infection, and perinatal outcomes. Obese women had significantly higher rates of gestational diabetes (OR 3.8), preeclampsia (OR 3.1), emergency caesarean (OR 2.4), and wound infection (OR 2.9) compared to normal-weight controls. Neonatal macrosomia was 4.2 times more common in obese pregnancies. Shoulder dystocia occurred exclusively in deliveries from obese women. BMI above 40 kg/m2 was associated with a substantially worse composite outcome score than class I obesity. The study establishes a quantified obesity-outcome association profile for Lagos tertiary births and recommends pre-conception weight management counselling, early GDM screening, and obesity-specific antenatal monitoring protocols in Lagos teaching hospitals. Keywords: maternal obesity, adverse obstetric outcomes, gestational diabetes, Lagos, BMI