Extremely high BMI is tied to postpartum hemorrhage

  • Cummings KF & al.
  • J Obstet Gynaecol Can
  • 11 Jul 2018

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • The duration of the third stage of labor and prevalence of postpartum hemorrhage are increased in extremely obese pregnant women.

Why this matters

  • The rates of obesity are rising worldwide.
  • Obesity is associated with increased maternal and neonatal morbidity.
  • Preconception counseling may help to reduce risks for maternal morbidity.

Key results

  • Women with extreme obesity were more likely to deliver at an earlier gestational age (P=.0046).
  • Their infants were more likely to have lower Apgar scores (P<.0001 had similar birth weights to children of normal-weight women>
  • Women with BMI ≥40 kg/m2 had a longer duration of the third stage of labor compared with normal-weight women (P=.03).
  • Women with BMI ≥40 kg/m2 were more likely to have a postpartum hemorrhage compared with normal-weight women (10.89% vs 3.2%; P=.01).
  • Women with extreme obesity were more likely to require uterotonics at delivery (16.3% vs 8.3%; P=.04).

Study design

  • Retrospective cohort study.
  • Vaginal deliveries in women with BMI ≥40 kg/m2 (n=147) compared with women with BMI 2 (n=157).
  • Maternal and neonatal complications were compared.
  • Funding: None.

Limitations

  • The management of the third stage of labor was not controlled for in all deliveries.

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