The Impact of Maternal Obesity on the Incidence of Adverse Pregnancy Outcomes in High-Risk Term Pregnancies

Wake Forest University, Winston-Salem, North Carolina 27157, USA.
American Journal of Perinatology (Impact Factor: 1.91). 05/2009; 26(5):345-9. DOI: 10.1055/s-0028-1110084
Source: PubMed


We investigated the impact of maternal obesity on pregnancy outcomes. Women with normal or obese body mass index (BMI) who delivered singleton infants at term were identified from a perinatal database. Rates of pregnancy complications and neonatal outcomes were compared between women with normal prepregnancy BMI (20 to 24.9 kg/m (2), N = 9171) and those with an obese prepregnancy BMI (> or = 30, N = 3744). Rates of pregnancy complications and neonatal outcomes were also evaluated by the level of obesity (obese [30 to 34.9 kg/m (2), N = 2106], severe obesity [35 to 39.9 kg/m (2), N = 953], and morbid obesity [> or = 40 kg/m (2), N = 685]). Rates of gestational diabetes (12.0% versus 3.7%, P < 0.001, odds ratio [95% confidence interval] = 3.5 [3.0, 4.1]) and gestational hypertension (30.9% versus 9.0%, P < 0.001, odds ratio [95% confidence interval] = 4.5 [4.1, 5.0]) were higher for obese versus normal BMI gravidas, respectively. Women with morbid or severe obesity had a greater incidence of gestational diabetes than women with an obese (30 to 34.9 kg/m (2)) or normal BMI (14.1%, 16.4%, 9.6%, and 3.7%, respectively; P < 0.05). The incidence of gestational hypertension increased with maternal BMI (9.0% normal, 25.5% obese, 33.7% severe, 43.4% morbid; all pairwise comparisons P < 0.05). Obese versus normal BMI was associated with more higher-level nursery admissions (8.2% versus 5.8%) and large-for-gestational age infants (12.3% versus 6.5%; P < 0.001). Obesity places a term pregnancy at risk for adverse maternal and neonatal outcomes.

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    • "In 45 studies of pre-pregnancy categories of the BMI, 10 studies were according to the recommendation of Abrams and Parker [40], [41], [43], [45], [49], [55], [58], [62], [64], [80], 24 studies were according to the classification set by the WHO [16], [42], [47], [48], [51]–[54], [56], [57], [65], [69]–[79], [81], [82], 8 studies were according to the IOM recommendations [44], [46], [50], [60], [61], [66]–[68], 2 studies were according to the classification proposed by the WGOC [13], [59] and 1 study was according to the APS [63]. According to the BW categories, SGA were investigated in 16 studies [13], [16], [41], [47], [48], [51], [53]–[57], [61], [66], [69]–[71], LGA in 21 studies [13], [16], [40], [42], [47]–[51], [53]–[57], [59]–[61], [66], [69]–[71], LBW in 10 studies [41], [43], [45], [46], [48], [61], [63], [65], [68], [71], HBW in 12 studies [41]–[43], [45], [46], [49], [58], [61], [63], [65], [67], [71] and macrosomia in 10 studies [44], [48]–[50], [52], [53], [57], [58], [62], [64]. "
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