ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1584650
Maternal Obesity in Low-Resource Settings: A Multicenter Cohort Study of Labor and Neonatal Outcomes in Guinea
Provisionally accepted
Abdourahamane Diallo1,2Elhadj Mamoudou Bah2,3Ibrahima Koussy Bah1,2Telly Sy1,2
Lothaire Ayadjenou Hounga4
Fiona Corbaz4*David Desseauve5- 1Ignace Deen Hospital, Conakry, Guinea
- 2Gamal Abdel Nasser University of Conakry, Conakry, Equatorial Guinea
- 3Department of Gynecology and Obstetrics, National Donka Hospital, Conakry, Guinea
- 4Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Vaud, Switzerland
- 5Centre Hospitalier Universitaire de Grenoble, La Tronche, Rhône-Alpes, France
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Objective To evaluate the impact of maternal obesity on obstetrical outcomes, including labor and delivery parameters, as well as maternal and neonatal prognosis. Study design This observational multicenter cohort study was conducted over six months in Conakry, Guinea's two busiest maternity hospitals. A total of 295 obese women (Body Mass Index (BMI) > 30 kg/m2) and 590 normal-weight women (BMI 18.5-24.9 kg/m2) were included. Obstetrical characteristics and outcomes were compared between obese and normal-weight parturients. Results Compared to normal-weight women, obese parturients had significantly higher risks of labor induction (RR=1.6, 95% CI [1.1-2.3]), occipital-posterior fetal position (RR=1.8, 95% CI [1.3-2.8]), the prolonged second stage of labor (RR=1.7, 95% CI [1.2-2.3]), and oxytocin administration for uterine hypo-contractility (RR=1.8, 95% CI [1.3-2.4]). Increased rates were also observed for episiotomy (RR=2.5, 95% CI [1.6-3.9]), vacuum-assisted delivery (RR=1.9, 95% CI [1.1-3.6]), cesarean section (RR=1.7, 95% CI [1.3-4.4]), postpartum hemorrhage (RR=1.8, 95% CI [1.3-5.2]), and post-cesarean wound infection (RR=3.3, 95% CI [2.2-19.6]). Neonates born to obese women were at increased risk of perinatal asphyxia (RR=2.9, 95% CI [1.3-6.4]), low APGAR score both at one minute (RR=1.7, 95% CI [1.3-2.2]) and ten minutes (RR=1.7, 95% CI [1.2-2.5]), and the need for neonatal resuscitation (RR=1.6, 95% CI [1.2-2.1]). No significant differences were observed between groups regarding the risk of breech presentation, the type of cephalic presentation (occipital-anterior versus occipital-posterior), or neonatal mortality. Conclusion In low-income settings, maternal obesity is associated with a significantly increased risk of adverse labor, delivery, and perinatal outcomes – mirroring patterns observed in higher-resource contexts. These findings underscore the need for enhanced healthcare provider training and the implementation of targeted maternal weight management strategies. Moreover, obstetrical protocols and clinical guidelines should be adapted based on maternal BMI to address better the specific risks associated with obesity in pregnancy.
Keywords: Obesity, Pregnancy, delivery, Childbirth, Labor, prognosis, Guinea, Conakry
Received: 27 Feb 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Diallo, Bah, Koussy Bah, Sy, Hounga, Corbaz and Desseauve. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fiona Corbaz, fiona.corbaz@hotmail.com
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