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Am J Perinatol 2016; 33(12): 1198-1204
DOI: 10.1055/s-0036-1586122
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Maternal Super Obesity and Neonatal Morbidity after Term Cesarean Delivery

Marcela C. Smid
1   Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Catherine J. Vladutiu
1   Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Sarah K. Dotters-Katz
1   Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Tracy A. Manuck
1   Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Kim A. Boggess
1   Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
David M. Stamilio
1   Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill, North Carolina
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Publikationsverlauf

10. Juni 2016

13. Juni 2016

Publikationsdatum:
27. Juli 2016 (online)

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Abstract

Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m2) and neonatal morbidity among neonates born via cesarean delivery (CD).

Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m2, 30 to 39.9 kg/m2, 40 to 49.9 kg/m2, and ≥ 50 kg/m2. Primary outcomes included acute (5-minute Apgar score < 5, cardiopulmonary resuscitation and ventilator support < 24 hours, neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity. Odds of neonatal morbidity were estimated for each BMI category adjusting for clinical and operative characteristics.

Results Of 41,262 maternal–neonatal dyads, 36% of women were nonobese, 49% had BMI of 30 to 39.9 kg/m2, 12% had BMI of 40 to 49.9 kg/m2, and 3% were super obese. Compared with nonobese women, super obese women had twofold odds of acute (5 vs. 10%; adjusted odds ratio [aOR]: 1.81, 95% confidence interval [CI]: 1.59–2.73) and severe (3 vs. 6%; aOR: 2.08; 95% CI: 1.59–2.73) neonatal morbidity.

Conclusion Among term infants delivered via CD, maternal super obesity is associated with increased risk of neonatal morbidity.

Keywords

cesarean delivery - neonatal morbidity - obesity - super obesity

Note

This paper was presented at the 2016 Society for Maternal-Fetal Medicine's Annual Meeting in Atlanta, GA, as two poster presentations (final abstract IDs: 221 and 650).