Subscribe to RSS
DOI: 10.1055/s-0031-1280851
Maternal Obesity and Nonstress Testing
Publication History
Publication Date:
09 June 2011 (online)
ABSTRACT
We evaluated the impact of maternal obesity on the characteristics and results of nonstress tests (NST). This prospective 1-year cohort study included 2026 NSTs performed on 575 consecutively chosen women with singleton gestations ≥32 weeks and no known fetal anomalies. Body mass index (BMI) class was determined at the first prenatal visit. The primary outcome was the duration of fetal heart rate monitoring before a reactive result. Obese women were not more likely to have nonreactive NST results. The mean duration before obtaining a reactive result was unaffected by obesity after controlling for diabetes and gestational age. The overall number of NSTs per patient was higher in obese than in nonobese women (3.9 versus 3.1, p < 0.01). More tests per patient are performed among obese subjects, yet the ability to perform an NST and the duration before obtaining a final result were unaffected by obesity.
KEYWORDS
Obesity - pregnancy - nonstress test - fetal surveillance
REFERENCES
- 1 Catalano P M. Management of obesity in pregnancy. Obstet Gynecol. 2007; 109 (2 Pt 1) 419-433
- 2 Boney C M, Verma A, Tucker R, Vohr B R. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics. 2005; 115 e290-e296
- 3 Chu S Y, Kim S Y, Lau J et al.. Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol. 2007; 197 223-228
- 4 Baron C M, Girling L G, Mathieson A L et al.. Obstetrical and neonatal outcomes in obese parturients. J Matern Fetal Neonatal Med. 2010; 23 906-913
- 5 Briese V, Voigt M, Wisser J, Borchardt U, Straube S. Risks of pregnancy and birth in obese primiparous women: an analysis of German perinatal statistics. Arch Gynecol Obstet [serial online] 2010 Jan 23. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20098995?dopt=abstract Accessed September 10, 2010
- 6 Farley D M, Choi J, Dudley D J et al.. Placental amino acid transport and placental leptin resistance in pregnancies complicated by maternal obesity. Placenta. 2010; 31 718-724
- 7 Heerwagen M J, Miller M R, Barbour L A, Friedman J E. Maternal obesity and fetal metabolic programming: a fertile epigenetic soil. Am J Physiol Regul Integr Comp Physiol. 2010; 299 R711-R722
- 8 ACOG Practice Bulletin. Antepartum fetal surveillance. Number 9, October 1999 (replaces Technical Bulletin Number 188, January 1994). Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet. 2000; 68 175-185
- 9 Signore C, Freeman R K, Spong C Y. Antenatal testing-a reevaluation: executive summary of a Eunice Kennedy Shriver National Institute of Child Health and Human Development workshop. Obstet Gynecol. 2009; 113 687-701
- 10 Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000; 894 i-xii, 1–253
- 11 National Institutes of Health . Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—The Evidence Report. Obes Res. 1998; 6 (Suppl 2) 51S-209S
- 12 Borgatta L, Shrout P E, Divon M Y. Reliability and reproducibility of nonstress test readings. Am J Obstet Gynecol. 1988; 159 554-558
- 13 Bracero L A, Morgan S, Byrne D W. Comparison of visual and computerized interpretation of nonstress test results in a randomized controlled trial. Am J Obstet Gynecol. 1999; 181 (5 Pt 1) 1254-1258
- 14 Rayburn W F, Motley M E, Zuspan F P. Conditions affecting nonstress test results. Obstet Gynecol. 1982; 59 490-493
- 15 Castro L C, Avina R L. Maternal obesity and pregnancy outcomes. Curr Opin Obstet Gynecol. 2002; 14 601-606
- 16 Vasudevan C, Renfrew M, McGuire W. Fetal and perinatal consequences of maternal obesity. Arch Dis Child Fetal Neonatal Ed [serial online] 2010 Jun 7. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20530101?dopt=abstract Accessed September 1, 2010
Steffen BrownM.D.
Department of Obstetrics and Gynecology, MSC 10 5580, 1 University of New Mexico
Albuquerque, NM 87131-0001
Email: Stbrown@salud.unm.edu