Maternal super-obesity (body mass index > or = 50) and adverse pregnancy outcomes.
OBJECTIVE
To determine if pregnancy complications are increased in super-obese (a body mass index (BMI) of 50 or more) compared to other, less obese parturients.


METHODS
Cross-sectional study.


METHODS
All 19,700 eligible women, including 425 (2.2%) super-obese women with singleton births between 1996 and 2007 delivering at a tertiary referral center, identified using a perinatal research database.


METHODS
Bivariate and trend analyses were used to assess the relation between super-obesity and various pregnancy complications compared to other well-established BMI categories. Adjusted odds ratios (ORs) were calculated using multivariable logistic regression techniques.


METHODS
Outcomes for adjusted and unadjusted analyses were small-for-gestational age (SGA) birth, large-for-gestational age (LGA) birth, preeclampsia, gestational diabetes mellitus (GDM), fetal death, preterm birth, placental abruption, cesarean delivery, and Apgar scores < 7.


RESULTS
Compared to all other obese and non-obese women, super-obese women had the highest rates of preeclampsia, GDM, LGA, and cesarean delivery (all p < 0.05 for trend test). Super-obesity was also associated with a 44% reduction in SGA compared to all other women (OR 0.55, 95% confidence interval (CI) 0.40-0.76) and a 25% reduction compared to other, less obese women (OR 0.75, 95% CI 0.54-1.03). Super-obesity was positively associated with LGA, GDM, preeclampsia, cesarean delivery, and a 5-minute Apgar score < 7 compared to all other women after controlling for important confounders.


CONCLUSIONS
Super-obesity is associated with higher rates of pregnancy complications compared to women of all other BMI classes, including other obese women.
Alanis
Mark Christopher
MC
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. alanis@musc.edu
Goodnight
William H
WH
Hill
Elizabeth G
EG
Robinson
Christopher J
CJ
Villers
Margaret S
MS
Johnson
Donna D
DD
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D015992:Body Mass Index; D015984:Causality; D002585:Cesarean Section / Q000706:statistics & numerical data; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000175:diagnosis / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012307:Risk Factors; D014481:United States / Q000453:epidemiology