Takeaway
- Obesity is an independent risk factor for adverse perinatal outcomes and maternal comorbidities.
- Obesity plus comorbidities increases most risks compared with obesity alone.
Why this matters
- A recent meta-analysis identified maternal BMI >30 kg/m2 as a strong risk factor for foetal macrosomia, low Apgar score, instrumental vaginal delivery, gestational diabetes and pre-eclampsia.
Key results
- Obese women had a higher probability of at least 1 comorbidity compared with nonobese women (21.7% vs 6.6%).
- Relative risks (RRs) with obesity alone (95% CIs):
- Cesarean delivery (CD): 1.52 (1.48-1.56);
- Induction of labour: 1.54 (1.49-1.59);
- Shoulder dystocia: 1.53 (1.29-1.80);
- Macrosomia: 1.96 (1.89-2.04); and
- Respiratory distress of newborn: 1.23 (1.15-1.32).
- RRs with obesity plus comorbidity:
- CD: 1.84 (1.76-1.91);
- Induction of labour: 2.60 (2.49-2.71);
- Shoulder dystocia: 2.78 (2.14-3.55);
- Macrosomia: 1.84 (1.70-1.99); and
- Respiratory distress of newborn: 2.03 (1.85-2.23).
Study design
- Retrospective cohort study.
- Cohort obtained from a database of women delivering singleton infants in Switzerland between 2005 and 2016 (n=324,664 births).
- Exposures included prepregnancy weight, diabetes, and hypertensive disorders of pregnancy.
- Obesity defined as BMI ≥30 kg/m2.
- Funding: None disclosed.
Limitations
- Population studied had a low rate of obesity.
References
References