Perinatal outcomes and satisfaction with care in women with high body mass index.
BACKGROUND
The majority of studies on pregnant women with high body mass index (BMI) have focused on medical complications and birth outcome, rather than these women's encounters with health care providers. The aims were to identify the proportion of pregnant women with high BMIs (≥30); compare maternal characteristics and pregnancy and birth outcomes; and assess the experiences of prenatal, intrapartum, and postnatal care in women with high (≥30) and lower (<30) BMIs.


METHODS
Data were collected through questionnaires and antenatal records from 919 women recruited in mid-pregnancy at 3 hospitals in the north of Sweden, with a follow-up questionnaire 2 months after birth.


RESULTS
The prevalence of obesity was 15.2%. Women with high BMIs were more often aged 35 years or older and less likely to have a university education. They had more negative attitudes regarding being pregnant and reported more childbirth fear compared to women with lower BMIs, but they did not differ in regard to their feelings about the approaching birth or the first weeks with the newborn. They reported more pregnancy complications and had less continuity of caregiver. High BMI was associated with labor induction and emergency cesarean birth. No differences were found in birth complications; birth experience; or satisfaction with prenatal, intrapartum, or postnatal care.


CONCLUSIONS
The findings reveal that women who are obese have more complicated pregnancies and births but are generally satisfied with the care they receive. There are some differences in the way they experience care. Health care providers have a delicate task to provide sufficient information about health risks while still offering respect, encouragement, and support.
Mid Sweden University, Holmgatan 10, SE 85170 Sundsvall, Sweden. ingegerd.hildingsson@miun.se
Ingegerd
I
Hildingsson
Jan
J
Thomas
D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D015992:Body Mass Index; D002585:Cesarean Section; D003266:Continuity of Patient Care; D004522:Educational Status; D005239:Fear; D005260:Female; D006801:Humans; D007751:Labor, Induced; D009765:Obesity / Q000453:epidemiology / Q000523:psychology; D007744:Obstetric Labor Complications; D017060:Patient Satisfaction; D018743:Perinatal Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012016:Reference Values; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology