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

Tara A. Lynch; Amol Malshe; Sarah Colihan; Jeffrey Meyers; Dongmei Li; Conisha Holloman; Eleazar Soto-Torres; Courtney Olson-Chen

doi:10.1055/s-0039-1698833

American Journal of Perinatology, Table of Contents

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

¹Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Rochester Medical Center, Rochester, New York

,

Amol Malshe

¹Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Rochester Medical Center, Rochester, New York

,

Sarah Colihan

²Department of Obstetrics and Gynecology, Albany Medical Center, Albany, New York

,

Jeffrey Meyers

³Department of Pediatrics, University of Rochester Medical Center, Rochester, New York

,

Dongmei Li

⁴Department of Clinical and Translational Research, Department of Obstetrics and Gynecology, Department of Public Health Sciences, University of Rochester, Rochester, New York

,

Conisha Holloman

⁵Department of Obstetrics and Gynecology, Winnie Palmer Hospital for Women and Babies, Orlando Health, Orlando, Florida

,

Eleazar Soto-Torres

⁶Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Texas–Houston, Houston, Texas

,

Courtney Olson-Chen

¹Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Rochester Medical Center, Rochester, New York

› Author Affiliations

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

Full Text

References

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