title: Increased maternal BMI is associated with an increased risk of minor complications during pregnancy with consequent cost implications.
abstract: OBJECTIVE
  To investigate the effect of maternal body mass index (BMI) on minor complications, associated additional medication use during pregnancy and the consequent cost implications.
  
  
  METHODS
  Retrospective analysis of case notes.
  
  
  METHODS
  Labour wards, tertiary referral hospital, Royal Infirmary Edinburgh, UK. Population Six hundred and fifty-one women with a singleton pregnancy over four separate time periods in 2007 and 2008.
  
  
  METHODS
  Descriptive statistics, univariate and multivariate logistic regression analysis and cost analysis using standard techniques and inflation indices.
  
  
  METHODS
  Minor complications, use of medications during pregnancy and consequent incremental costs from the perspective of the National Health Service (NHS).
  
  
  RESULTS
  42.4% of women were overweight or obese (BMI > or = 25 kg/m(2)). Higher BMI during the first trimester (BMI > or = 30 kg/m(2) compared with BMI < 25 kg/m(2)) was associated with an increased risk of minor complications including symphysis pubis dysfunction (OR 3.97; 95% CI 2.19-7.18), heartburn (OR 2.65; 95% CI 1.42-4.94) and chest infection (OR 8.71; 95% 2.20-34.44) and with drugs used to treat these complications including Gaviscon (OR 3.52; 95% CI 1.78-6.96). The mean incremental (additional) NHS costs per woman for treating minor complications increased with maternal BMI were 15.45 pounds/woman, 17.64 pounds/woman and 48.66 pounds/woman for BMI < 25 kg/m(2), BMI > or = 25 to <30 kg/m(2) and BMI > or = 30 kg/m(2) respectively.
  
  
  CONCLUSIONS
  Increased maternal BMI is associated with increased risk of developing minor complications during pregnancy; use of medications associated with treating these conditions and has significant NHS costs.
authors.affiliation: Centre for Reproductive Biology, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK. fiona.denison@ed.ac.uk
authors.forename: F C
authors.initials: FC
authors.lastname: Denison
authors.forename: G
authors.initials: G
authors.lastname: Norrie
authors.forename: B
authors.initials: B
authors.lastname: Graham
authors.forename: J
authors.initials: J
authors.lastname: Lynch
authors.forename: N
authors.initials: N
authors.lastname: Harper
authors.forename: R M
authors.initials: RM
authors.lastname: Reynolds
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D017048:Health Care Costs; D006801:Humans; D009765:Obesity / Q000150:complications / Q000191:economics / Q000453:epidemiology*; D050177:Overweight / Q000150:complications / Q000191:economics / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D011261:Pregnancy Trimester, First; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D013222:State Medicine / Q000191:economics; D055815:Young Adult