Elevated maternal BMI tied to increased risk for adverse pregnancy and delivery outcomes

  • Doi L & al.
  • BMJ Open
  • 20 Feb 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Women with overweight and obesity were at higher risk for pregnancy and delivery complications including gestational hypertension, gestational diabetes, pre-eclampsia, labour induction and caesarean delivery.
  • Risk increased with an increase in body mass index (BMI).

Why this matters

  • Physicians should be encouraged and trained to deliver promising dietary and lifestyle interventions to women at higher risk for overweight and obesity prior to conception and to control excessive weight gain during pregnancy.

Study design

  • Retrospective cohort study of 132 899 women with first-time singleton deliveries (71 538 with normal weight, 36 188 with overweight, and 25173 with obesity).
  • Funding: Scottish Collaboration for Public Health Research and Policy and others.

Key results

  • Women with overweight and obesity vs those with normal weight were at increased risk for:
    • gestational hypertension (OR, 1.61 [95% CI, 1.49-1.74] and 2.48 [95% CI, 2.30-2.68], respectively);
    • gestational diabetes (OR, 2.14 [95% CI, 1.86-2.46] and 8.25 [95% CI, 7.33-9.30], respectively);
    • pre-eclampsia (OR, 1.46 [95% CI, 1.32-1.33] and 2.07 [95% CI, 1.87-2.29], respectively);
    • labour induction (OR, 1.28 [95% CI, 1.23-1.33] and 1.69 [95% CI, 1.62-1.76], respectively); and
    • emergency caesarean section (OR, 1.82 [95% CI, 1.74-1.91] and 3.14 [95% CI, 3.00-3.29], respectively).
  • Similarly, the risk for large-for-gestational age was higher in women with overweight (OR, 1.27; 95% CI, 1.23-1.30) and obesity (OR, 1.53; 95% CI, 1.48-1.58) vs those with normal weight.

Limitations

  • Retrospective design.