[Obstetrical complications of morbid obesity].
ABSTRACT To determine whether morbidly obese women have an increased risk of pregnancy complications and adverse perinatal outcome.
In a retrospective study, 2472 women with morbid obesity, defined as a body mass index (BMI) more than 40 were compared with normal weight women (BMI 20-25). Fisher and Student tests were used for statistical analysis.
In the group of morbidly obese mothers (BMI greater than 40) as compared with the normal weight mothers, there was an increased risk of the following outcomes: gravidic hypertension (7.7 vs 0.5%; p<0.05). preeclampsia (11.5 vs 2%; p<0.05), gestational diabetes (15.4 vs 1.8%; p<0.05), cesarean delivery (50 vs 15.4%; p<0.05), and macrosomia (42.3 vs 10.3%; p<0.05). However, we noted a lower rate of prematurity in the obese group (0 vs 11%). Even when morbidly obese women with preexisting diabetes and chronic hypertension were excluded from the analysis, significant differences in the perinatal outcomes still persisted.
Morbid obesity appears to be an independent risk factor for perinatal and gestational complications.
SourceAvailable from: Zachary M Ferraro[Show abstract] [Hide abstract]
ABSTRACT: Objective. To determine a precise estimate for the contribution of maternal obesity to macrosomia. Data Sources. The search strategy included database searches in 2011 of PubMed, Medline (In-Process & Other Non-Indexed Citations and Ovid Medline, 1950-2011), and EMBASE Classic + EMBASE. Appropriate search terms were used for each database. Reference lists of retrieved articles and review articles were cross-referenced. Methods of Study Selection. All studies that examined the relationship between maternal obesity (BMI ≥30 kg/m(2)) (pregravid or at 1st prenatal visit) and fetal macrosomia (birth weight ≥4000 g, ≥4500 g, or ≥90th percentile) were considered for inclusion. Tabulation, Integration, and Results. Data regarding the outcomes of interest and study quality were independently extracted by two reviewers. Results from the meta-analysis showed that maternal obesity is associated with fetal overgrowth, defined as birth weight ≥ 4000 g (OR 2.17, 95% CI 1.92, 2.45), birth weight ≥4500 g (OR 2.77,95% CI 2.22, 3.45), and birth weight ≥90% ile for gestational age (OR 2.42, 95% CI 2.16, 2.72). Conclusion. Maternal obesity appears to play a significant role in the development of fetal overgrowth. There is a critical need for effective personal and public health initiatives designed to decrease prepregnancy weight and optimize gestational weight gain.BioMed Research International 01/2014; 2014:640291. DOI:10.1155/2014/640291 · 2.71 Impact Factor
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ABSTRACT: As a result of the ongoing obesity epidemic, obstetricians worldwide will be forced to deal with more obese, and even morbidly obese, pregnant women. These women have an increased risk of gestational hypertension, pre-eclampsia, gestational diabetes and stillbirth. Obese women are also more likely to have prolonged labor, cesarean deliveries, macrosomic infants and infants with shoulder dystocia. It is a major obstetric challenge to inform obese women about these potential risks in clear terms and, at a later date, to solve the acute obstetric problems concerning these patients during delivery. Pregnancy could be seen as a window during which women are more open to counseling about the risks of being obese and are more likely to make behavioral changes that may persist and improve their health later in life.Expert Review of Obstetrics & Gynecology 08/2006; 1(1):73-80. DOI:10.1586/17474126.96.36.199
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ABSTRACT: To monitor the maternal mortality which is an indicator of the quality of obstetric and intensive care, France has a specific approach since 1996. Recently linkages have been introduced to improve the inclusion of cases. Here are the results for the 2007 to 2009 period. The identification of the pregnancy associated deaths is lying on different data bases that are medical causes of death, birth register and hospital discharges. To document the cases, confidential enquiries are conducted by two assessors on the field; a committee of medical experts analyses the documents, select the underlying cause and assess the quality of health care. Two hundred and fifty-four obstetric deaths were identified from 2007 to 2009 giving the maternal mortality ratio (MMR) of 10.3 per 100,000 births. The maternal age and nationality, the region of deaths are associated to the MMR. The haemorrhages are the leading cause but their ratio is 1.9 versus 2.5 previously; this decrease results from the postpartum haemorrhage by uterine atony going down. The suboptimal care are still frequent (60%) but slightly less than before. The linkage method should be pursuited. Maternal mortality is rather stable in France. We may reach more reduction as deaths due to atony decreased as suboptimal care did.Journal de Gynécologie Obstétrique et Biologie de la Reproduction 09/2013; · 0.62 Impact Factor