Obesity and pregnancy outcomes: Do the relationships differ by maternal region of birth? A retrospective cohort study.
BACKGROUND
We aimed to determine whether the association between obesity and a range of adverse maternal and perinatal outcomes differed in South Asian and Australian and New Zealand born women.


METHODS
A retrospective cohort study of singleton births in South Asian (SA) and Australian/New Zealand (AUS/NZ) born women at an Australian hospital between 2009 and 2013. The interaction between maternal region of birth and obesity on a range of maternal and perinatal outcomes was assessed using multivariate logistic regression.


RESULTS
Obesity was more strongly associated with gestational hypertension/Preeclampsia/HELLP and Gestational Diabetes Mellitus in AUS/NZ born women (p = 0.001 and p < 0.001, respectively for interaction) and was only associated with shoulder dystocia in SA born women (p = 0.006 for interaction). There was some evidence that obesity was more strongly related with admission to NICU/Special care nursery (SCN) (p = 0.06 for interaction) and any perinatal morbidity (p = 0.05 for interaction) in SA born women.


CONCLUSIONS
Interventions targeted at reducing maternal obesity will have different impacts in SA compared to AUS/NZ born women.
The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Vic, 3168, Australia. Miranda.davies@hudson.org.au.
Miranda
M
Davies-Tuck
The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Vic, 3168, Australia.|Monash Health, Monash Medical Centre, Clayton, Australia.|Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.
Joanne C
JC
Mockler
Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.
Lynne
L
Stewart
Monash Health, Monash Medical Centre, Clayton, Australia.
Michelle
M
Knight
The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Vic, 3168, Australia.|Monash Health, Monash Medical Centre, Clayton, Australia.|Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia.
Euan M
EM
Wallace
Maternal region of birth and Pregnancy outcomes; Obesity
Am J Obstet Gynecol. 2013 Sep;209(3):214.e1-11
23635421
BJOG. 2013 May;120(6):732-42; discussion 742-3
23510385
Matern Child Health J. 2011 Apr;15(3):289-301
20306221
Intern Med J. 2011 Jul;41(7):581-2
21762341
Obstet Gynecol. 2005 Oct;106(4):802-7
16199639
BMJ. 2013 Jan 24;346:f108
23349424
Obes Rev. 2007 Sep;8(5):385-94
17716296
BMJ Open. 2015 Aug 10;5(8):e007232
26260346
J Intern Med. 2007 Oct;262(4):408-14
17875176
BMC Pregnancy Childbirth. 2014 Dec 07;14:404
25481783
Aust N Z J Obstet Gynaecol. 2012 Oct;52(5):433-9
23045986
Obes Rev. 2015 Aug;16(8):621-38
26016557
Obstet Gynecol. 2012 Jun;119(6):1227-33
22617588
Obesity (Silver Spring). 2013 May;21(5):1046-55
23784909
J Epidemiol Community Health. 2011 Aug;65(8):696-701
20719806
Lancet. 2004 Jan 10;363(9403):157-63
14726171
PLoS One. 2013;8(1):e53749
23341993
Med J Aust. 2012 Sep 3;197(5):278-81
22938125
Semin Perinatol. 2014 Jun;38(4):189-93
24863023
BMC Pregnancy Childbirth. 2013 May 01;13:100
23634802
Acta Obstet Gynecol Scand. 1998 Mar;77(3):303-6
9539276
BMC Pregnancy Childbirth. 2010 Sep 17;10:56
20849609
Am J Obstet Gynecol. 2004 Jul;191(1):83-9
15295346
Obes Rev. 2015 Sep;16(9):758-70
26094567
J Matern Fetal Neonatal Med. 2015 May;28(7):829-35
24939628
BJOG. 2012 Feb;119(3):276-82
22044452