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Am J Perinatol 2020; 37(05): 467-474
DOI: 10.1055/s-0039-1698833
SMFM Fellowship Series Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Impact of Maternal Obesity on Perinatal Outcomes in Preterm Prelabor Rupture of Membranes ≥34 Weeks

Tara A. Lynch 
1   Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Rochester Medical Center, Rochester, New York
,
Amol Malshe
1   Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Rochester Medical Center, Rochester, New York
,
Sarah Colihan
2   Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York
,
Jeffrey Meyers
3   Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
,
Dongmei Li
4   Department of Clinical and Translational Research, Department of Obstetrics and Gynecology, Department of Public Health Sciences, University of Rochester, Rochester, New York
,
Conisha Holloman
5   Department of Obstetrics and Gynecology, Winnie Palmer Hospital for Women and Babies, Orlando Health, Orlando, Florida
,
Eleazar Soto-Torres
6   Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Texas–Houston, Houston, Texas
,
Courtney Olson-Chen
1   Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Rochester Medical Center, Rochester, New York
› Author Affiliations
Further Information

Publication History

25 April 2019

07 September 2019

Publication Date:
18 November 2019 (online)

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Abstract

Objective This study aimed to compare pregnancy outcomes in obese and nonobese women with preterm prelabor rupture of membranes (PPROM) ≥34 weeks.

Study Design The present study is a secondary analysis of a multicenter retrospective cohort of singletons with PPROM from 2011 to 2017. Women with a delivery body mass index (BMI) ≥30 kg/m2 (obese) were compared with women with a BMI < 30 kg/m2 (nonobese). Pregnancies were stratified based on delivery policies of expectant management until 35 weeks versus immediate delivery ≥34 weeks. The primary outcome was a composite neonatal outcome (neonatal sepsis, antibiotic administration for duration >72 hours after delivery or respiratory support). Univariate analysis and general estimating equations models including maternal age, delivery timing, mode of delivery, hospital, and gestational age were used with p < 0.05 level of significance.

Results Among 259 pregnancies, 47% were obese. Pregnant women with obesity had increased composite neonatal outcome versus nonobese pregnancies (adjusted odds ratio [aOR] = 1.48 [95% confidence interval (CI): 1.01–2.17]). Obesity was also associated with increased neonatal antibiotic administration for a duration >72 hours after delivery, respiratory support, ventilation, oxygen supplementation, and surfactant administration. When stratified by delivery policies there was no significant difference in perinatal outcomes based on obesity.

Conclusion Obese women with PPROM ≥34 weeks have an increased odds of adverse neonatal respiratory and infectious outcomes compared with nonobese women.

Keywords

obesity - preterm prelabor rupture of membranes - late preterm delivery
 

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