The impact of body mass index and weight gain during pregnancy on puerperal complications after spontaneous vaginal delivery.
BACKGROUND
We studied the effect of the prepregnancy body mass index (BMI) and weight gain during pregnancy on the rate of puerperal complications after spontaneous vaginal delivery.


METHODS
This is a prospective cohort study of 11,114 women delivered spontaneously between 36 and 43 week's gestation at a university hospital, between January 1996 and December 2000. Postpartum complications were analyzed according to prepregnancy BMI category (low < 19.8; normal 19.8-26; high 26.1-29; obese > 29) and weight gain during pregnancy. Weight gain was defined as low, normal or high according to the National Academy of Science recommendations for BMI.


RESULTS
Overall, 7.3% women had complications. Anemia and readmission were significantly more common in lean women than in women with normal BMI (3.5% versus 2.6%; P = .021 and 1.0% versus 0.3%; P < .001, respectively). Obese women had significantly more infectious complications (especially urinary tract infection) than women with normal BMI (6.3% versus 3.8%; P = .005).


CONCLUSIONS
These results suggest that obese women should be screened for puerperal urinary tract infection. Weight gain during pregnancy has no influence on puerperal complications.
Giuliani
Albrecht
A
Department of Obstetrics and Gynecology, University of Graz, Austria. giuliani@kfunigraz.ac.at
Tamussino
Karl
K
Basver
Asli
A
Haas
Josef
J
Petru
Edgar
E
D000293:Adolescent; D000328:Adult; D001317:Austria / Q000453:epidemiology; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening; D008875:Middle Aged; D011247:Pregnancy / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology*; D011645:Puerperal Infection / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D015430:Weight Gain