Maternal obesity and adverse pregnancy outcomes - register-based study

  • Ijäs H & al.
  • PLoS ONE
  • 1 Jan 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Maternal overweight/obesity without gestational diabetes (GDM) was associated with an increase in the risk for macrosomia and caesarean delivery.
  • These risks were amplified when overweight/obesity was accompanied by GDM

Why this matters

  • This study warrants the need for follow-up in obese women even with normal glucose tolerance.
  • Findings highlight the importance of weight management among women of fertile age.

Study design

  • Women with a singleton pregnancy who delivered in 2009 were identified from the Finnish Medical Birth Register (n=24,577; mean age, 30.0 years).
  • Based on oral glucose tolerance test women were divided into GDM and no GDM group.
  • Primary outcomes: macrosomia, caesarean delivery, and treatment at neonatal ward.
  • Funding: Academy of Finland; others.

Key results

  • Incidence of GDM in normal weight (body mass index [BMI], ≤24.9 kg/m2), overweight (BMI, 25.0-29.9 kg/m2) and obese (BMI, ≥30 kg/m2) women: 17.0%, 21.6% and 36.9%, respectively.
  • Overweight and obese women without GDM were at an increased risk for:
    • macrosomia: aOR, 1.18 (95% CI, 1.09-1.28) and 1.50 (95% CI, 1.19-1.88); and
    • caesarean delivery: aOR, 1.17 (95% CI, 1.07-1.28) and 1.52 (95% CI, 1.37-1.69), respectively.
  • Among normal-weight women, those with GDM vs without GDM showed no significant increase in the risks for:
    • macrosomia (aOR, 1.17; 95% CI, 0.85-1.62); and
    • caesarean delivery (aOR, 1.10; 95% CI, 0.96-1.27).
  • The interaction between GDM and BMI was significant for macrosomia, caesarean delivery, neonatal intensive care unit treatment, delivery induction, preterm delivery and neonatal hypoglycaemia (P<.001>

Limitations

  • Study may not be representative of all pregnant women.