The Impact of Maternal Obesity on the Incidence of Adverse Pregnancy Outcomes in High-Risk Term Pregnancies

Saju Joy; Niki Istwan; Debbie Rhea; Cheryl Desch; Gary Stanziano

doi:10.1055/s-0028-1110084

American Journal of Perinatology, Table of Contents

Am J Perinatol 2009; 26(5): 345-349
DOI: 10.1055/s-0028-1110084

The Impact of Maternal Obesity on the Incidence of Adverse Pregnancy Outcomes in High-Risk Term Pregnancies

Saju Joy¹ , Niki Istwan² , Debbie Rhea² , Cheryl Desch² , Gary Stanziano²

¹Wake Forest University, Winston-Salem, North Carolina
²Matria Healthcare, Department of Clinical Research, Marietta, Georgia

Abstract

ABSTRACT

We investigated the impact of maternal obesity on pregnancy outcomes. Women with normal or obese body mass index (BMI) who delivered singleton infants at term were identified from a perinatal database. Rates of pregnancy complications and neonatal outcomes were compared between women with normal prepregnancy BMI (20 to 24.9 kg/m², n = 9171) and those with an obese prepregnancy BMI (≥ 30, n = 3744). Rates of pregnancy complications and neonatal outcomes were also evaluated by the level of obesity (obese [30 to 34.9 kg/m², n = 2106], severe obesity [35 to 39.9 kg/m², n = 953], and morbid obesity [≥ 40 kg/m², n = 685]). Rates of gestational diabetes (12.0% versus 3.7%, p < 0.001, odds ratio [95% confidence interval] = 3.5 [3.0, 4.1]) and gestational hypertension (30.9% versus 9.0%, p < 0.001, odds ratio [95% confidence interval] = 4.5 [4.1, 5.0]) were higher for obese versus normal BMI gravidas, respectively. Women with morbid or severe obesity had a greater incidence of gestational diabetes than women with an obese (30 to 34.9 kg/m²) or normal BMI (14.1%, 16.4%, 9.6%, and 3.7%, respectively; p < 0.05). The incidence of gestational hypertension increased with maternal BMI (9.0% normal, 25.5% obese, 33.7% severe, 43.4% morbid; all pairwise comparisons p < 0.05). Obese versus normal BMI was associated with more higher-level nursery admissions (8.2% versus 5.8%) and large-for-gestational age infants (12.3% versus 6.5%; p < 0.001). Obesity places a term pregnancy at risk for adverse maternal and neonatal outcomes.

KEYWORDS

Maternal obesity - body mass index - pregnancy outcomes - neonatal outcomes

Full Text

References

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Saju JoyM.D. M.S.

Wake Forest University Health Sciences, Department of OB/GYN

Maternal-Fetal Medicine, Medical Center Boulevard, Winston-Salem, NC 27157

Email: sjoy@wfubmc.edu