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The impact of body mass index on maternal and neonatal outcomes: a retrospective study in a UK obstetric population, 2004–2011
Author(s) -
ScottPillai R,
Spence D,
Cardwell CR,
Hunter A,
Holmes VA
Publication year - 2013
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12193
Subject(s) - medicine , overweight , underweight , body mass index , gestational diabetes , obstetrics , population , caesarean section , retrospective cohort study , pregnancy , obesity , pediatrics , gestation , environmental health , biology , genetics
Objective To assess the prevalence of overweight and obesity, and the impact of body mass index ( BMI ) on maternal and neonatal outcomes, in a UK obstetric population. Design Retrospective study. Setting A tertiary referral unit in Northern Ireland. Population A total of 30 298 singleton pregnancies over an 8‐year period, 2004–2011. Methods Women were categorised according to W orld H ealth O rganization classification: underweight ( BMI < 18.50 kg/m 2 ); normal weight ( BMI 18.50–24.99 kg/m 2 ; reference group); overweight ( BMI 25.00–29.99 kg/m 2 ); obese class I ( BMI 30.00–34.99 kg/m 2 ); obese class II ( BMI 35–39.99 kg/m 2 ); and obese class III ( BMI ≥ 40 kg/m 2 ). Maternal and neonatal outcomes were examined using logistic regression, adjusted for confounding variables. Main outcome measures Maternal and neonatal outcomes. Results Compared with women of normal weight, women who were overweight or obese class I were at significantly increased risk of hypertensive disorders of pregnancy ( OR 1.9, 99% CI 1.7–2.3; OR 3.5, 99% CI 2.9–4.2); gestational diabetes mellitus ( OR 1.7, 99% CI 1.3–2.3; OR 3.7, 99% CI 2.8–5.0); induction of labour ( OR 1.2, 99% CI 1.1–1.3; OR 1.3, 99% CI 1.2–1.5); caesarean section ( OR 1.4, 99% CI 1.3–1.5; OR 1.8, 99% CI 1.6–2.0); postpartum haemorrhage ( OR 1.4, 99% CI 1.3–1.5; OR 1.8, 1.6–2.0); and macrosomia ( OR 1.5, 99% CI 1.3–1.6; OR 1.9, 99% CI 1.6–2.2), with the risks increasing for obese classes II and III . Women in obese class III were at increased risk of preterm delivery ( OR 1.6, 99% CI 1.1–2.5), stillbirth ( OR 3.0, 99% CI 1.0–9.3), postnatal stay > 5 days ( OR 2.1, 99% CI 1.5–3.1), and infant requiring admission to a neonatal unit ( OR 1.6, 99% CI 1.0–2.6). Conclusions By categorising women into overweight and obesity subclassifications (classes I – III ), this study clearly demonstrates an increasing risk of adverse outcomes across BMI categories, with women who are overweight also at significant risk.