Association between gynaecological disorders and body mass index in a South African cohort: a retrospective observational study

A retrospective observational study of new patients who visited the gynaecology outpatient clinic at Tygerberg Hospital, South Africa, between February and June 2019 was conducted to determine the association between body mass index (BMI) and gynaecological disorders. BMI was calculated and analysed concerning the presenting complaint and final diagnosis. From the sample of 651 patients, 18.4% had a normal BMI and 47.3% were classified as overweight or obese class 1. Older age was associated with a higher BMI (p = .013). Hypertension was most prevalent (26.7%) and associated with excess weight (p < .001). Disorders significantly associated with obesity were infertility (odds ratio [OR] 1.013, 95% confidence interval [CI] 0.992–1.033, p = .001), polycystic ovarian syndrome (OR 1.058, 95% CI 1.028–1.089, p = .006), pelvic organ prolapse (OR 1.027, 95% CI 0.995–1.060, p = .0291) and postmenopausal bleeding (OR 1.038, 95% CI 1.009–1.068, p = .048). Chronic pelvic pain and endometriosis were associated with a low BMI. IMPACT STATEMENTWhat is already known on this subject? It is well known that obesity has multiple negative effects on health. It affects women's health on many levels including their endocrine balance as well as pressure effects on the pelvic floor. The association between gynaecological disorders and excess weight has been described mainly in the context of separate gynaecological conditions.What the results of study add? This study described the large numbers of women with obesity in the South African context. It adds to the body of knowledge by looking at the association of BMI, not only obesity, and a large range of the most seen gynaecological conditions in the study setting.What the implications are of these findings for clinical practice and/or further research? This study highlights the importance of lifestyle and nutritional implications on women's health. For clinical practice, this knowledge needs to be applied with every opportunity to counsel women on how their weight can affect their gynaecological health. The focus of further research should focus on the most effective strategies to combat obesity in a holistic patient-centered approach.