Very high BMI and pregnancy add up to high risk

  • McCall SJ & al.
  • PLoS One
  • 1 Jan 2019

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

  • Super obese women (BMI >50 kg/m2) are at risk for maternal and neonatal pregnancy complications.

Why this matters

  • Rates of obesity are increasing worldwide.
  • Preconception counseling to achieve lower BMI may help reduce pregnancy complications.
  • Increased antepartum surveillance is important for super obese pregnant women.

Key results

  • No maternal deaths noted.
  • Compared with women without super obesity, thrombotic event odds were higher among super obese women (OR, 9.39; 95% CI, 1.15-76.43).
  • Women with BMI >50 kg/m2 had increased risk for (aORs, using model 3 for adjustment):
    • Preeclampsia: 4.81 (P<.001>
    • Cesarean delivery: 3.07 (P<.001>
    • Induction of labor: 2.48 (P<.001>
    • Cesarian delivery wound infection: 7.25 (P<.001>
    • Macrosomia: 8.05 (P<.001 and>
    • 5-minute Apgar 
  • Risk not significantly increased for perinatal death: unadjusted OR, 1.78 (95% CI, 0.75-4.25).

Study design

  • International population-based cohort study using secondary data analysis.
  • Cohort identified from separate national studies in the UK and Australia.
  • Pregnant women with BMI >50 kg/m2 (n=932) compared with pregnant women with BMI 2 (n=1232).
  • Funding: Individual funding from Nuffield Department of Population Health and Medical Research Council, NIHR.

Limitations

  • Only variables listed in data sets could be used.
  • Does not show causation.