title: Neonatal outcomes in obese mothers: a population-based analysis.
abstract: BACKGROUND
  If it is well known that obesity increases morbidity for both mother and fetus and is associated with a variety of adverse reproductive outcomes, then few studies have assessed the relation between obesity and neonatal outcomes. This is the aim of the present study after taking into account type of labor and delivery, as well as social, medical and hospital characteristics in a population-based analysis.
  
  
  METHODS
  This study used 2009 data from the Belgian birth register data pertaining to the regions of Brussels and Wallonia and included 38,675 consecutive births. Odds ratio and 95% confidence intervals for admission to neonatal intensive care unit, Apgar score, and perinatal mortality were calculated by logistic regression analyses adjusting for medical, social and hospital characteristics using obesity as the primary independent variable. The impact of analyzing all delivery sites together was tested using mixed-effect analyses.
  
  
  RESULTS
  The adjusted odds ratio for neonatal intensive care unit admission was higher for obese mothers by 38% compared to non-obese mothers (95% confidence interval (CI): 1.22-1.56), and by 45% (CI: 1.21-1.73) and 34% (CI: 1.10-1.63) after spontaneous and induced labour respectively. The adjusted odds ratio was 1.18 (CI: 0.86-1.63) after caesarean section. The adjusted odds ratio for 1 minute Apgar score inferior to 7 was higher for obese mothers by 31% compared to non-obese mothers (CI: 1.15-1.49) and by 26% (CI: 1.04-1.52) and 38% (CI: 1.12-1.69) after spontaneous and induced labour respectively. The adjusted odds ratio was 1.50 (CI: 0.96-2.36) after caesarean section. The adjusted odds ratio for perinatal mortality was 1.36 (CI: 0.75-2.45) for obese mothers compared to non-obese mothers.
  
  
  CONCLUSIONS
  Neonatal admission to intensive care and low Apgar scores were more likely to occur in infants from obese mothers, both after spontaneous and induced labor.
authors: Perinatal Epidemiology Center 'CEpiP' School of Public Health, University Hospital Erasme and Faculty of Medicine, Université Libre de Bruxelles, Brussels 1070, Belgium. aminsart@ulb.ac.be
authors: Anne-Frederique
authors: AF
authors: Minsart
authors: Pierre
authors: P
authors: Buekens
authors: Myriam
authors: M
authors: De Spiegelaere
authors: Yvon
authors: Y
authors: Englert
mesh_terms: D000328:Adult; D001034:Apgar Score; D001530:Belgium / Q000453:epidemiology; D001724:Birth Weight / Q000502:physiology; D015992:Body Mass Index; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D016015:Logistic Models; D009765:Obesity; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications; D012042:Registries; D012307:Risk Factors
references: Acta Obstet Gynecol Scand. 2004 Nov;83(11):1022-9
references: 15488115
references: BJOG. 2008 May;115(6):720-5
references: 18410655
references: BJOG. 2005 Jun;112(6):768-72
references: 15924535
references: Arch Gynecol Obstet. 2007 Jan;275(1):39-43
references: 16967276
references: BMJ. 2000 May 6;320(7244):1240-3
references: 10797032
references: Acta Obstet Gynecol Scand. 2012 Mar;91(3):363-71
references: 22122755
references: Obstet Gynecol. 2004 Feb;103(2):219-24
references: 14754687
references: Am J Obstet Gynecol. 1992 Oct;167(4 Pt 1):958-62
references: 1415432
references: Eur J Med Res. 2009 May 14;14(5):216-22
references: 19541579
references: Obstet Gynecol. 1998 Jan;91(1):97-102
references: 9464729
references: Obesity (Silver Spring). 2006 Jan;14(1):165-71
references: 16493135
references: Int J Obes Relat Metab Disord. 2001 Aug;25(8):1175-82
references: 11477502
references: Obes Rev. 2008 Nov;9(6):635-83
references: 18673307
references: Duodecim. 1993;109(4):309-16
references: 8013335
references: Obes Rev. 2008 Mar;9(2):140-50
references: 18221480
references: Am J Obstet Gynecol. 2006 Apr;194(4):911-5
references: 16580275
references: Obstet Gynecol. 2003 Nov;102(5 Pt 1):1022-7
references: 14672480
references: Med J Aust. 2006 Jan 16;184(2):56-9
references: 16411868
references: Am J Clin Nutr. 2000 May;71(5 Suppl):1242S-8S
references: 10799397
references: Obstet Gynecol. 2011 Aug;118(2 Pt 1):305-312
references: 21775846
references: BJOG. 2006 Oct;113(10):1117-25
references: 16903839
references: Obes Rev. 2009 Jan;10(1):28-35
references: 19021871
references: Matern Child Health J. 2006 Sep;10(5 Suppl):S153-6
references: 16927160
references: Med J Aust. 2012 Feb 20;196(3):184-8
references: 22339524
references: BJOG. 2006 Oct;113(10):1173-7
references: 16972860