Introduction: Obesity in pregnancy is associated with numerous ante partum complications and neonatal morbidity. Modest weight loss prior to pregnancy and reduced weight gain during gestation could bring substantial advantages to obstetric outcome. Objectives: To compare maternal complications and labor outcome in obese and non-obese women Methodology: It is a retrospective comparative study conducted at the Department of Gynaecology and Obstetrics, Unit 1, Civil Hospital, Karachi from Dec 2009 to Dec 2010. A sample size of 220 gravid women is selected by Non Probability Convenience sampling technique. In these 110 obese women as cases was compared with 110 non-obese women as controls, booked at <20 weeks of gestation and data was collected regarding maternal complication, mode of delivery and neonatal outcome by trained medical officers. Data was entered and analyzed by SPSS version 11.0 through descriptive analysis, chi-square test and independent sample t test. The p-values of <0.05 was considered significant. Results: Pregnancy induced hypertension was present in 9 (8.2%) women in control group and 21(19.1%) in cases (p=0.0184). Gestational diabetes was seen in one (0.9%) in control compared to 8(7.3%) in obese women (p=0.0172). Obese women were found to be at increased risk of caesarean section [17 (15.5%) vs. 39(35.4%)] with significant p = 0.002. Apgar score at 1 and 10 minute was low in cases compared to controls (p=0.0001). Conclusion: Obese women are at increased risk of pregnancy induced maternal obesity and associated with an increased risk of hypertension, gestational diabetes mellitus and severe adverse pregnancy outcome
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