Association Between Prepregnancy Body Mass Index and Severe Maternal Morbidity

Lisonkova, Sarka; Muraca, Giulia M.; Potts, Jayson; Liauw, Jessica; Chan, Wee‐Shian; Skoll, Amanda; Lim, Kenneth

doi:10.1097/01.aoa.0000542350.56459.ef

Cited by 7 publications

(19 citation statements)

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“…We found no association between obesity and severe PPH. Previous results on the association between the association between obesity and PPH have been mixed, although our results are similar to the recent findings by Lisonkova et al in a large population‐based sample.…”

Section: Commentsupporting

confidence: 91%

“…A Dutch case‐control study of 4561 low‐risk pregnant women found a dose‐response relationship between overweight, obesity, and morbid obesity and composite SMM outcome . A population‐based cohort of 743 630 women in the United States similarly found a dose‐response relationship between elevated BMI and composite SMM . A population register‐based study of 292 253 singleton births in Finland also reported an increased risk of composite SMM among obese women .…”

Section: Commentmentioning

confidence: 95%

“…Maternal outcomes associated with obesity include higher rates of pre‐eclampsia and gestational diabetes, prolonged labour progression, higher rates of caesarean delivery, and an increased risk for postpartum haemorrhage independent of mode of delivery in some settings . Despite the increased incidence of complications during pregnancy and delivery among obese women, few studies have investigated the effect of maternal obesity on severe complications leading to profound alterations in the mother's health, that is, severe maternal morbidity (SMM) . These studies have utilised varying definitions of the SMM composite outcome and approaches to case ascertainment.…”

Section: Introductionmentioning

confidence: 99%

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Associations between maternal obesity and severe maternal morbidity: Findings from the French EPIMOMS population‐based study

Siddiqui

Azria

Howell

et al. 2018

Paediatric Perinatal Epid

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Background Maternal obesity is increasing. There is growing evidence of its effect on severe maternal morbidity. We assessed prepregnancy obesity as an independent risk factor for severe maternal morbidity by timing and cause. Methods We designed a case‐control analysis within the EPIMOMS prospective population‐based study conducted in six French regions in 2012‐2013 (182 309 women who delivered at ≥22 weeks). Cases were all women who experienced severe maternal morbidity during pregnancy to 42 days postpartum as per a multicriteria definition derived by national expert consensus (n = 2540, severe maternal morbidity prevalence 1.4%). Controls were randomly selected from the same health centres (n = 3651). The association between obesity and severe maternal morbidity was assessed from fitting multivariable logistic regression models: overall, by timing (antepartum and intrapartum/ postpartum), and by cause. Results Prepregnancy obesity was associated with overall severe maternal morbidity (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.14, 1.59) and antepartum severe maternal morbidity (OR 2.07, 95% CI 1.61, 2.65), but not with intra/postpartum severe maternal morbidity (OR 1.15, 95% CI 0.96, 1.38). Among antepartum severe maternal morbidity, severe hypertensive disorders were most strongly associated with obesity (OR 2.50, 95% CI 1.85, 3.40) but the risk of antepartum severe maternal morbidity due to other causes was also increased among obese women (OR 1.64, 95% CI 1.13, 2.37). Obesity was not associated with severe postpartum haemorrhage (OR 1.12, 95% CI 0.92, 1.37). Conclusion Obesity is associated with an increased risk of antepartum, but not intra/ postpartum, severe maternal morbidity.

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Section: Commentsupporting

confidence: 91%

Section: Commentmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Associations between maternal obesity and severe maternal morbidity: Findings from the French EPIMOMS population‐based study

Siddiqui

Azria

Howell

et al. 2018

Paediatric Perinatal Epid

View full text Add to dashboard Cite

show abstract

“…A multiple imputation technique was used to recover the missing values assuming that data were missing at random—which may or may not be true. Of note, an even higher proportion of records with missing BMI data (9%) was reported in a recent related analysis, but carefully addressed through a sensitivity analysis that demonstrated no effect on the main associations of interest.…”

mentioning

confidence: 98%

“…The authors nested a case‐control analysis into a population‐based prospective study in France (EPIMOMS) specifically designed to examine SMM in six regions of the country. By comparison, other recent studies exploring the same associations employed administrative data, such as hospital discharge or health registry data . Cases were all women from a source population of over 180 000 pregnant women (ie, about one‐fifth of deliveries in France and thought to be nationally representative) who developed SMM .…”

mentioning

confidence: 99%