Open AccessMaternal super‐obesity (body mass index ≥ 50) and adverse pregnancy outcomes
Author(s) -
ALANIS MARK CHRISTOPHER,
GOODNIGHT WILLIAM H.,
HILL ELIZABETH G.,
ROBINSON CHRISTOPHER J.,
VILLERS MARGARET S.,
JOHNSON DONNA D.
Publication year - 2010
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016341003657884
Subject(s) - medicine , obstetrics , gestational diabetes , body mass index , odds ratio , preeclampsia , pregnancy , placental abruption , obesity , apgar score , population , confidence interval , gestational age , gestation , environmental health , biology , genetics
Objective . To determine if pregnancy complications are increased in super‐obese (a body mass index (BMI) of 50 or more) compared to other, less obese parturients. Design . Cross‐sectional study. Setting and population . All 19,700 eligible women, including 425 (2.2%) super‐obese women with singleton births between 1996 and 2007 delivering at a tertiary referral center, identified using a perinatal research database. Methods . Bivariate and trend analyses were used to assess the relation between super‐obesity and various pregnancy complications compared to other well‐established BMI categories. Adjusted odds ratios (ORs) were calculated using multivariable logistic regression techniques. Main outcome measures . Outcomes for adjusted and unadjusted analyses were small‐for‐gestational age (SGA) birth, large‐for‐gestational age (LGA) birth, preeclampsia, gestational diabetes mellitus (GDM), fetal death, preterm birth, placental abruption, cesarean delivery, and Apgar scores < 7. Results . Compared to all other obese and non‐obese women, super‐obese women had the highest rates of preeclampsia, GDM, LGA, and cesarean delivery (all p < 0.05 for trend test). Super‐obesity was also associated with a 44% reduction in SGA compared to all other women (OR 0.55, 95% confidence interval (CI) 0.40–0.76) and a 25% reduction compared to other, less obese women (OR 0.75, 95% CI 0.54–1.03). Super‐obesity was positively associated with LGA, GDM, preeclampsia, cesarean delivery, and a 5‐minute Apgar score < 7 compared to all other women after controlling for important confounders. Conclusion . Super‐obesity is associated with higher rates of pregnancy complications compared to women of all other BMI classes, including other obese women.