The clinical outcomes of unplanned pregnancy in severely obese women.
OBJECTIVE
The objective of this study was to compare the clinical outcomes of unplanned pregnancies among severely obese women with those of planned pregnancies.


METHODS
This prospective cohort study included severely obese women (Body Mass Index [BMI] ≥ 40.0 kg/m(2)) who delivered a baby weighing ≥ 500 g over 5 years 2009-2013 in a large university hospital. Maternal weight and height were measured and BMI was calculated at the first prenatal visit.


RESULTS
Of the 650 women, the mean BMI was 43.8 kg/m(2), mean age was 31.6 years, and 30.0% (n = 195) were nulliparous. Prenatal complications including gestational diabetes mellitus (GDM), hypertensive and thromboembolic disorders occurred in 56.6% (n = 368). Compared with planned pregnancies (58.2%, n = 378), those that were unplanned (41.8%, n = 272) were associated with increased prepregnancy risk factors including essential hypertension (4.0% versus 1.6%, p = 0.03) and depression (6.6% versus 3.2%, p = 0.03). Unplanned pregnancy was associated with a higher macrosomia rate (birthweight > 4.5 kg) compared with planned pregnancies (p = 0.03). This was not explained by a higher GDM rate in unplanned pregnancies. Compared with planned pregnancies, unplanned pregnancies were not associated with increased adverse fetomaternal outcomes.


CONCLUSIONS
Despite increased prepregnancy risk factors, in severely obese women, unplanned pregnancies were not associated with increased prenatal complications or adverse pregnancy outcomes compared with planned pregnancies.
a UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital , Dublin , Ireland.
Aoife
A
McKeating
a UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital , Dublin , Ireland.
Patrick J
PJ
Maguire
a UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital , Dublin , Ireland.
Maria
M
Farren
a UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital , Dublin , Ireland.
Niamh
N
Daly
a UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital , Dublin , Ireland.
Sharon R
SR
Sheehan
a UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital , Dublin , Ireland.
Michael J
MJ
Turner
D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007494:Ireland / Q000453:epidemiology; D009767:Obesity, Morbid / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D049168:Pregnancy, Unplanned; D013923:Thromboembolism / Q000453:epidemiology
High-risk pregnancy; severe maternal obesity; unplanned pregnancy