Obesity is an independent risk factor for adverse perinatal outcomes

  • Aubry EM & al.
  • Sci Rep
  • 5 Jul 2019

  • International Clinical Digest
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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.