Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study

Abstract

Background Obesity in pregnancy is increasing worldwide, reaching epidemic proportions in many countries and frequently creating challenges for obstetricians. We conducted this study to assess the effects of maternal obesity on maternal and perinatal outcomes. Methods A historical cohort study was performed on 16,609 women who delivered singleton babies in a 5-year period (2013–2017). Data were retrieved from the Cruces Perinatal Database (CPD) and only women whose prepregnancy body mass index (BMI) was known were included. Women were categorized according to the World Health Organization (WHO) classification: normal weight (BMI 20–24.9 kg/m2) and obesity (BMI ≥ 30 kg/m2). Obstetric, perinatal and neonatal outcomes were compared, and adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated using the normal-weight group as the reference. Results Compared to women of normal weight (n = 9778), obese women (n = 2207) had a higher risk of preeclampsia (aOR 2.199, 95% CI: 1.46–3.29), rectovaginal group B streptococcus colonization (aOR 1.299, 95% CI: 1.14–1.47), induction of labor (aOR 1.593, 95% CI: 1.44–1.75), cesarean section (aOR 2.755, 95% CI: 2.46–3.08), cesarean section in women with a history of cesarean delivery (aOR 1.409, 95% CI: 1.03–1.92), fetal weight ≥4000 g (aOR 2.090, 95% CI: 1.803–2.422) and admission to the neonatal intensive care unit (NICU) (aOR 1.341, 95% CI: 1.12–1.59). No association was found with preterm birth (aOR 0.936, 95% CI: 0.77–1.13), stillbirth (aOR 0.921, 95% CI: 0.41–2.02) or neonatal mortality (aOR 2.205, 95% CI: 0.86–5.62). Conclusion Maternal obesity is associated with a higher risk of adverse pregnancy and perinatal outcomes. Pregnancy in this population of women should be considered and managed as high risk.

Relationship between maternal body mass index with the onset of breastfeeding and its associated problems: an online survey

“…Among the main strengths of the study, the large sample size and the scarcity of studies focused on specific aspects of breastfeeding such as starting in the first hour or skin-to-skin contact can be highlighted. On the other hand, the prevalence of obesity in our study was similar to other studies, such as that by Parveen et al [2], who observed a prevalence of obesity of 31.6%, and the one by Melchor et al [32], with a prevalence of 18.4%. Because of this, we believe that our sample provides an adequate representation of women with high BMIs.…”

Body mass index and gestational weight gain in pregnant women with gestational diabetes and its relation with adverse maternal and fetal outcome

“…28 Various Indian and international studies depicting similar results were found. [29][30][31] Also, we found higher odds for preterm, macrosomia, IUFD and NICU admissions in study group. In a cohort study by Doi relation between high maternal BMI and pregnancy outcome was studied.…”

“…33,34 Studies by Doi et al, Su et al, Castillejos et al, and Melchor et al also endorses similar results. 29,[30][31][32]35…”

Maternal ve Fetal Sağlık İçin Büyük Tehlike: Maternal Obezite

“…Çalışma sonunda gebelerin %22,6'sının IOM'un önerdiği vücut ağırlığından daha azını, %50,0'ının ise önerilenden daha fazlasını kazandığı gözlenmiştir [3]. Fetal gelişimin devamlılığı ve sağlıklı bir doğum için önerilen vücut ağırlığı kazanımı sağlanmalıdır [4]. Ancak yapılan çalışmalarda hafif şişman ve/veya obez kadınlarda önerilenden daha az ağırlık kazanımının fetal gelişime olumsuz bir katkısının olmadığı gözlenmiştir.…”

“…Ancak yapılan çalışmalarda hafif şişman ve/veya obez kadınlarda önerilenden daha az ağırlık kazanımının fetal gelişime olumsuz bir katkısının olmadığı gözlenmiştir. Bu sebeple hafif şişman/obez gebelerde önerilenden daha az ağırlık kazanmış ancak herhangi bir fetal sorun yaşanmamış ise gebeyi daha fazla ağırlık kazandırmaya yönlendirmek maternal ve fetal sonuçlar açısından bir iyileşme getirmeyeceği için gerekli değildir [4,5]. Ayrıca çalışma sonuçlarına göre IOM'un önerdiği değerlerin altında ağırlık kazanmış obez ve hafif şişman gebelerde maternal ve fetal herhangi bir komplikasyon gözlenmemiş, bebeklerin doğum ağırlıklarının normal sınırlarda olduğu saptanmıştır.…”