title: The impact of maternal obesity on the incidence of adverse pregnancy outcomes in high-risk term pregnancies.
abstract: We investigated the impact of maternal obesity on pregnancy outcomes. Women with normal or obese body mass index (BMI) who delivered singleton infants at term were identified from a perinatal database. Rates of pregnancy complications and neonatal outcomes were compared between women with normal prepregnancy BMI (20 to 24.9 kg/m (2), N = 9171) and those with an obese prepregnancy BMI (> or = 30, N = 3744). Rates of pregnancy complications and neonatal outcomes were also evaluated by the level of obesity (obese [30 to 34.9 kg/m (2), N = 2106], severe obesity [35 to 39.9 kg/m (2), N = 953], and morbid obesity [> or = 40 kg/m (2), N = 685]). Rates of gestational diabetes (12.0% versus 3.7%, P < 0.001, odds ratio [95% confidence interval] = 3.5 [3.0, 4.1]) and gestational hypertension (30.9% versus 9.0%, P < 0.001, odds ratio [95% confidence interval] = 4.5 [4.1, 5.0]) were higher for obese versus normal BMI gravidas, respectively. Women with morbid or severe obesity had a greater incidence of gestational diabetes than women with an obese (30 to 34.9 kg/m (2)) or normal BMI (14.1%, 16.4%, 9.6%, and 3.7%, respectively; P < 0.05). The incidence of gestational hypertension increased with maternal BMI (9.0% normal, 25.5% obese, 33.7% severe, 43.4% morbid; all pairwise comparisons P < 0.05). Obese versus normal BMI was associated with more higher-level nursery admissions (8.2% versus 5.8%) and large-for-gestational age infants (12.3% versus 6.5%; P < 0.001). Obesity places a term pregnancy at risk for adverse maternal and neonatal outcomes.
authors.affiliation: Wake Forest University, Winston-Salem, North Carolina 27157, USA. sjoy@wfubmc.edu
authors.forename: Saju
authors.initials: S
authors.lastname: Joy
authors.forename: Niki
authors.initials: N
authors.lastname: Istwan
authors.forename: Debbie
authors.initials: D
authors.lastname: Rhea
authors.forename: Cheryl
authors.initials: C
authors.lastname: Desch
authors.forename: Gary
authors.initials: G
authors.lastname: Stanziano
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D015984:Causality; D015897:Comorbidity; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D005845:Georgia / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D017533:Marital Status; D008423:Maternal Age; D009765:Obesity / Q000145:classification / Q000453:epidemiology*; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology