Maternal morbid obesity and the risk of adverse pregnancy outcome.
OBJECTIVE
To evaluate whether morbidly obese women have an increased risk of pregnancy complications and adverse perinatal outcomes.


METHODS
In a prospective population-based cohort study, 3,480 women with morbid obesity, defined as a body mass index (BMI) more than 40, and 12,698 women with a BMI between 35.1 and 40 were compared with normal-weight women (BMI 19.8-26). The perinatal outcome of singletons born to women without insulin-dependent diabetes mellitus was evaluated after suitable adjustments.


RESULTS
In the group of morbidly obese mothers (BMI greater than 40) as compared with the normal-weight mothers, there was an increased risk of the following outcomes (adjusted odds ratio; 95% confidence interval): preeclampsia (4.82; 4.04, 5.74), antepartum stillbirth (2.79; 1.94, 4.02), cesarean delivery (2.69; 2.49, 2.90), instrumental delivery (1.34; 1.16, 1.56), shoulder dystocia (3.14; 1.86, 5.31), meconium aspiration (2.85; 1.60, 5.07), fetal distress (2.52; 2.12, 2.99), early neonatal death (3.41; 2.07, 5.63), and large-for-gestational age (3.82; 3.50, 4.16). The associations were similar for women with BMIs between 35.1 and 40 but to a lesser degree.


CONCLUSIONS
Maternal morbid obesity in early pregnancy is strongly associated with a number of pregnancy complications and perinatal conditions.


METHODS
II-2
Cedergren
Marie I
MI
Division of Obstetrics and Gynecology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, SE-581 85 Linköping, Sweden. marie.cedergren@lio.se
D000293:Adolescent; D000328:Adult; D001720:Birth Injuries / Q000453:epidemiology / Q000209:etiology; D015992:Body Mass Index; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D016001:Confidence Intervals; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000175:diagnosis; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors