Obstetrical complications of morbid obesity

Service de Gynécologie-Obstétrique et Médecine de la Reproduction.
Journal de Gynécologie Obstétrique et Biologie de la Reproduction (Impact Factor: 0.56). 01/2005; 33(8):739-44. DOI: 10.1016/S0368-2315(04)96636-7
Source: PubMed


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.

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    • "Additionally , women in group 4 were treated as a separate group despite the low number (n = 25). Morbidly obese women generally have higher complication rates than do obese women with a BMI between 30 and 40 [5] [8] [9]; however, the small sample size of this group limited the ability to observe significant differences compared with the reference group (group 1). Further, the study population originated from one department, which could have hampered the generalizability of the results. "
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    ABSTRACT: To determine whether obesity is an independent risk factor for cesarean delivery in Martinique. A retrospective study was performed using data for deliveries that occurred at the University Hospital of Fort de France between January and September 2010. Women were divided into four groups on the basis of body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters; <25 [group 1], 25-29 [group 2], 30-39 [group 3], and ≥40 [group 4]). Independent risk factors for cesarean delivery were identified through multivariate analysis. Overall, 1286 women were included. Mean weight gain was lower in groups 2 (9.9kg, 95% CI 9.2-10.7), 3 (5.7kg, 4.7-6.7), and 4 (1.0kg,-1.5 to 3.5), than in group 1 (12.3kg, 11.9-12.7; P<0.001 for all). In univariate analysis, cesarean deliveries were more frequent among nulliparous women in group 2 (P=0.007) and group 3 (P=0.053) than among those in group 1. In multivariate analysis, BMI was not associated with cesarean delivery (BMI 25-29: adjusted odds ratio 0.64, 95% CI 0.33-1.25; BMI ≥30: 0.61, 0.29-1.39). Obesity was not an independent risk factor for cesarean delivery. Weight control and a positive attitude towards trial of labor in obese women could have led to the findings. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · Aug 2015 · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
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    • "). Maternal morbid obesity, particularly in early pregnancy, is strongly associated with a number of pregnancy complications and peri-natal conditions (Satpathy et al., 2008). Morbidly obese mothers as compared with normal-weight mothers had an increased risk of the following outcomes: pre-eclampsia, ante-partum stillbirth, instrumental delivery, shoulder dystocia, meconium aspiration, foetal distress and early neonatal death in studies conducted in Europe (Cedergren, 2004; Grossetti et al., 2004). Maternal mid-upper arm circumference (MUAC) has been used as a potential indicator of maternal nutritional status. "

    Preview · Article · Mar 2015
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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.
    No preview · Article · Aug 2006 · Expert Review of Obstetrics & Gynecology
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