title: Pregnancy outcomes in a cohort of women with a preconception body mass index >50 kg/m².
abstract: We describe characteristics and risk factors regarding pregnancy outcome in women with a preconception body mass index (BMI) >50 kg/m² compared with women with BMI ≤50 kg/m² in a retrospective population cohort study in singleton pregnancies from the Danish Medical Birth Registry. Results were analyzed as relative risks by a two-proportion z-test. Women with preconception BMI >50 kg/m² smoked, developed gestational diabetes and pre-eclampsia, and needed induction of labor more frequently than mothers with BMI ≤50 kg/m². Examination of the case records showed that many attempted vaginal delivery without epidural analgesia, 21% needed an emergency cesarean section (compared with 12% among women with BMI ≤50 kg/m²), and 25% underwent general anesthesia in this context. Many neonates were macrosomic and 34% needed neonatal intensive care and early feeding compared with 6% of neonates from women with BMI ≤50 kg/m². Women with an extremely high preconception BMI develop more pregnancy complications and their neonates appear affected by this as well.
authors.affiliation: Department of Gynecology and Obstetrics, Holbæk Hospital, Holbæk, Denmark.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bonnesen
authors.forename: Niels J
authors.initials: NJ
authors.lastname: Secher
authors.forename: Lars K
authors.initials: LK
authors.lastname: Møller
authors.forename: Steen
authors.initials: S
authors.lastname: Rasmussen
authors.forename: Kirsten R
authors.initials: KR
authors.lastname: Andreasen
authors.forename: Kristina
authors.initials: K
authors.lastname: Renault
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D009765:Obesity / Q000150:complications*; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
keywords: Body mass index; adverse outcome; cesarean section; macrosomia; obesity; pregnancy