Survey of obstetric providers' views on the anesthetic risks of maternal obesity.
BACKGROUND
Maternal obesity is increasing in prevalence and associated with numerous complications. Surveys document that obstetricians recognize the obstetric and perinatal health risks of maternal obesity. To determine if they recognize the anesthetic risks and discuss them antenatally with obese patients, we surveyed all obstetric providers at a university-affiliated obstetric unit.


METHODS
The survey listed complications of obesity and pregnancy sampled from the literature, including eight anesthetic complications, ten prenatal obstetric complications, ten intrapartum or postpartum obstetric complications, five medical complications and five neonatal complications. Respondents reported if and when they routinely discuss each. Reported routine discussion rates were averaged across respondents and complication categories. We postulated that anesthetic aspects would be discussed less frequently than others.


RESULTS
Thirty-six of the 55 obstetric providers responded (65.5%). On average, anesthetic complications were discussed during prenatal care 13.5% of the time, less often than prenatal obstetric complications (48.5%, Wilcoxon signed rank test, P<0.0001), intrapartum or postpartum obstetric complications (40.0%, Wilcoxon signed rank test, P<0.0001) and medical complications (35.0%, Wilcoxon signed rank test, P=0.0001). The survey failed to demonstrate a statistically significant difference in the rate of discussion between anesthetic and neonatal complications (13.5% vs. 22.2%, Wilcoxon signed rank test, P=0.05). Twenty-four respondents reported that they did not routinely discuss any of the listed anesthetic complications with their obese patients in the prenatal period.


CONCLUSIONS
This preliminary study suggests that antenatal education about the anesthetic implications of obesity may not be part of routine prenatal care for obese pregnant women.
Mhyre
J M
JM
Department of Anesthesiology, Division of Obstetric Anesthesiology, Women's Hospital, University of Michigan Health System, Ann Arbor, Michigan 48109-0048, USA. jmmhyre@unimich.edu
Greenfield
M L V H
ML
Polley
L S
LS
D000758:Anesthesia / Q000009:adverse effects* / Q000706:statistics & numerical data; D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D003625:Data Collection / Q000379:methods; D005260:Female; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D009765:Obesity / Q000150:complications*; D009774:Obstetrics; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications; D011295:Prenatal Care; D018570:Risk Assessment; D012307:Risk Factors