Maternal superobesity and perinatal outcomes

Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.
American journal of obstetrics and gynecology (Impact Factor: 4.7). 05/2012; 206(5):417.e1-6. DOI: 10.1016/j.ajog.2012.02.037
Source: PubMed


The purpose of this study was to determine the effect of maternal superobesity (body mass index [BMI], ≥ 50 kg/m(2)) compared with morbid obesity (BMI, 40-49.9 kg/m(2)) or obesity (BMI, 30-39.9 kg/m(2)) on perinatal outcomes.
We conducted a retrospective cohort study of birth records that were linked to hospital discharge data for all liveborn singleton term infants who were born to obese Missouri residents from 2000-2006. We excluded major congenital anomalies and women with diabetes mellitus or chronic hypertension.
There were 64,272 births that met the study criteria, which included 1185 superobese mothers (1.8%). Superobese women were significantly more likely than obese women to have preeclampsia (adjusted relative risk [aRR], 1.7; 95% confidence interval [CI], 1.4-2.1), macrosomia (aRR, 1.8; 95% CI, 1.3-2.5), and cesarean delivery (aRR, 1.8; 95% CI, 1.5-2.1). Almost one-half of all superobese women (49.1%) delivered by cesarean section, and 33.8% of superobese nulliparous women underwent scheduled primary cesarean delivery.
Women with a BMI of ≥ 50 kg/m(2) are at significantly increased risk for perinatal complications compared with obese women with a lower BMI.

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    • "We found that BMI predicted preeclampsia (p = 0.010) at a cutoff value of 23.64 kg/m2 at a fixed FPR of 10% and 24.26 kg/m2 at a fixed FPR of 5%, even in a low-risk population with BMI < 25 kg/m2. This result is consistent with previous reports that obese women are at increased risk of developing preeclampsia [24,25]. "
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