title: Maternal superobesity and perinatal outcomes.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of maternal superobesity (body mass index [BMI], ≥ 50 kg/m(2)) compared with morbid obesity (BMI, 40-49.9 kg/m(2)) or obesity (BMI, 30-39.9 kg/m(2)) on perinatal outcomes.
  
  
  METHODS
  We conducted a retrospective cohort study of birth records that were linked to hospital discharge data for all liveborn singleton term infants who were born to obese Missouri residents from 2000-2006. We excluded major congenital anomalies and women with diabetes mellitus or chronic hypertension.
  
  
  RESULTS
  There were 64,272 births that met the study criteria, which included 1185 superobese mothers (1.8%). Superobese women were significantly more likely than obese women to have preeclampsia (adjusted relative risk [aRR], 1.7; 95% confidence interval [CI], 1.4-2.1), macrosomia (aRR, 1.8; 95% CI, 1.3-2.5), and cesarean delivery (aRR, 1.8; 95% CI, 1.5-2.1). Almost one-half of all superobese women (49.1%) delivered by cesarean section, and 33.8% of superobese nulliparous women underwent scheduled primary cesarean delivery.
  
  
  CONCLUSIONS
  Women with a BMI of ≥ 50 kg/m(2) are at significantly increased risk for perinatal complications compared with obese women with a lower BMI.
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA. marshani@ohsu.edu
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Marshall
authors.forename: Camelia
authors.initials: C
authors.lastname: Guild
authors.forename: Yvonne W
authors.initials: YW
authors.lastname: Cheng
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
authors.forename: Donna R
authors.initials: DR
authors.lastname: Halloran
mesh_terms: D000328:Adult; D001034:Apgar Score; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity; D009767:Obesity, Morbid; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012306:Risk