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Trends in obesity and impact on obstetric outcomes in a regional hospital in Victoria, Australia
Author(s) -
Ward Madeleine C.,
Agarwal Anju,
Bish Melanie,
James Rachel,
Faulks Fiona,
Pitson Jennifer,
Yuen Nicola,
Mnatzaganian George
Publication year - 2020
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.13035
Subject(s) - medicine , overweight , gestational diabetes , obesity , body mass index , caesarean section , population , obstetrics , shoulder dystocia , gestational hypertension , demography , preeclampsia , pregnancy , pediatrics , environmental health , gestation , sociology , biology , genetics
Aims Obesity‐related complications have been identified across the entire childbearing journey. This study investigated changes in obesity prevalence and their impact on obstetric outcomes in a regional hospital in Victoria, Australia. Methods All women delivering during 1 January 2010 and 31 December 2016 were eligible to participate. Trends over time and outcomes were assessed on body mass indices ( BMI ). Incidences of complications were compared by BMI categories. The effect of obesity on hospital length of stay (LoS) was further assessed using the Generalised Estimating Equations approach. Results During the study period a total of 6661 women of whom 27.5% were overweight, and 16.1, 7.7, and 5.5% were respectively obese class I, class II , and class III , contributed to 8838 births. An increased trend over time in the prevalence of obesity ( BMI > 35.0) ( P = 0.041) and a decreased trend for vaginal deliveries for the whole sample ( P = 0.003) were found. Multiple adverse outcomes were associated with increasing maternal BMI including increased risk of gestational diabetes, gestational hypertension, preeclampsia, emergency caesarean section, shoulder dystocia, macrosomia, and admission to special care. The multivariable analysis showed no associations between LoS and BMI . Conclusions Over a short period of seven years, this study provides evidence of a significant trend toward more obesity and fewer vaginal births in a non‐urban childbearing population, with increasing trends of poorer health outcomes. Assessing needs and risk factors tailored to this population is crucial to ensuring a model of care that safeguards a sustainable and effective regional maternity health service.