Impact of Maternal Obesity on Perinatal Outcomes in Preterm Prelabor Rupture of Membranes ≥34 Weeks

Abstract

Objective This study aimed to compare pregnancy outcomes in obese and nonobese women with preterm prelabor rupture of membranes (PPROM) ≥34 weeks. Study Design The present study is a secondary analysis of a multicenter retrospective cohort of singletons with PPROM from 2011 to 2017. Women with a delivery body mass index (BMI) ≥30 kg/m2 (obese) were compared with women with a BMI < 30 kg/m2 (nonobese). Pregnancies were stratified based on delivery policies of expectant management until 35 weeks versus immediate delivery ≥34 weeks. The primary outcome was a composite neonatal outcome (neonatal sepsis, antibiotic administration for duration >72 hours after delivery or respiratory support). Univariate analysis and general estimating equations models including maternal age, delivery timing, mode of delivery, hospital, and gestational age were used with p < 0.05 level of significance. Results Among 259 pregnancies, 47% were obese. Pregnant women with obesity had increased composite neonatal outcome versus nonobese pregnancies (adjusted odds ratio [aOR] = 1.48 [95% confidence interval (CI): 1.01–2.17]). Obesity was also associated with increased neonatal antibiotic administration for a duration >72 hours after delivery, respiratory support, ventilation, oxygen supplementation, and surfactant administration. When stratified by delivery policies there was no significant difference in perinatal outcomes based on obesity. Conclusion Obese women with PPROM ≥34 weeks have an increased odds of adverse neonatal respiratory and infectious outcomes compared with nonobese women.

Adverse perinatal outcomes in 665,244 term and post-term deliveries—a Norwegian population-based study

“…Regarding missing data, only 20% of our study population had a maternal body mass index record. Given that maternal obesity is associated with adverse perinatal outcomes (42), these missing data could be a potential confounder we could not investigate in this study.…”

Perinatal Nutritional and Metabolic Pathways: Early Origins of Chronic Lung Diseases

“…A meta-analysis of 84 clinical studies has shown a significantly increased risk of (induced) preterm labor in overweight and obese pregnancies (245). In addition, the risk of neonatal respiratory complications after premature birth is higher in obese vs. non-obese pregnancies (246,247).…”

“…In addition, the risk of neonatal respiratory complications after premature birth is higher in obese vs . non-obese pregnancies ( 246 , 247 ).…”

Mapeamento do excesso de peso em gestantes e prematuridade: uma revisão de escopo

“…O primeiro conjunto mostra as investigações que encontraram associação positiva entre excesso de peso gestacional e parto prematuro (Avci et al, 2014;Bhattacharya et al, 2007;Bhavadharini et al, 2017;Carnero et al, 2012;Chen et al, 2020;Cnattingius & Lambe, 2002;Djelantik et al, 2011;Dodd et al, 2011;Han et al, 2011;Hancke et al, 2015;Kim et al, 2017;Lutsiv et al, 2015;Marchi et al, 2015;Masho et al, 2013;Madan et al, 2010;Papachatzi et al, 2016;Parveen et al, 2017;Poston & Rishi, 2016;Rafei et al, 2016;Savitz et al, 2011;Su et al, 2020;Torloni et al, 2010;Wise et al, 2010;Yang et al, 2019;Zhong et al, 2010;Zhou et al, 2019) perfazendo um total de 64,2% dos estudos. O segundo grupo são artigos que não encontraram associação significativa entre essas variáveis, em um total de nove publicações (Aly et al, 2010;Aydin et al, 2010;Briese et al, 2011;Chen et al, 2010;Gonçalves et al, 2012;Lynch et al, 2019;Melchor et al, 2019;Palatnik et al, 2016;Puscasi et al, 2013). E o último grupo são de pesquisas que evidenciaram associação negativa entre excesso de peso na gravidez e prematuridade com um percentual de 14,2% (Asvanarunat, 2014;Jenabi & AslToghiri, 2011;Konje et al, 2016;Lynch et al, 2014;…”