title: The impact of body mass index and weight gain during pregnancy on puerperal complications after spontaneous vaginal delivery.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Graz, Austria. giuliani@kfunigraz.ac.at
authors.forename: Albrecht
authors.initials: A
authors.lastname: Giuliani
authors.forename: Karl
authors.initials: K
authors.lastname: Tamussino
authors.forename: Asli
authors.initials: A
authors.lastname: Basver
authors.forename: Josef
authors.initials: J
authors.lastname: Haas
authors.forename: Edgar
authors.initials: E
authors.lastname: Petru
mesh_terms: 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