Adverse pregnancy and neonatal outcomes seen in obese pregnant women even in the absence of chronic diseases.

According to a recent study published Ahead of Print in journal of obstetrics and gynecology, women who are obese have higher risk of adverse pregnancy and neonatal outcome.

The study was conducted as a retrospective cohort study using the medical records obtained from the Consortium on Safe Labor, from the year 2002-2008. 

Dr. Sung Soo Kim and her colleagues from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, examined records of singleton pregnancies among US women without any pre-pregnancy disease for obstetrics and neonatal complications based on prepregnancy BMI of mother.

The mothers were put into either of the 5 categories according to the BMI as normal weight (18.5-24.9 kg/m²), overweight (25-29.9), obese class I (30-34.9), obese class II (35-39.9), or obese class III (40 or greater).

The investigators looked in to 112,309 deliveries among 106,552 women.

The relative risk for developing gestational diabetes compared to normal weight women was 1.99 for overweight women, 2.94 for obese class I women, 3.97 for obese class II women, and 5.47 for obese class III women.

A similar risk profile was noted for gestational hypertensive disorders, gestational diabetes, cesarean delivery, and induction that increased in a dose response manner.

The neonatal risks also increase with increasing BMI like preterm birth at less than 32 weeks of gestation, large for gestational age (LGA), transient tachypnea, sepsis, and intensive care unit admission.

The percentage of LGA infants born to normal weight women was 7.9% that increased to 17.3% among obese class III women and relative risks increased to 1.52 (1.45-1.58), 1.74 (1.65-1.83), 1.93 (1.79-2.07), and 2.32 (2.14-2.52) as BMI category increased.

When all these adverse outcomes were grouped together and analyzed as a single composite variable, it was seen that obese women have a 18%-47% increased risk of any pregnancy complication than normal weight cohorts.

The researchers said “We found increased risks of relatively rare outcomes that other studies could not observe, including maternal acute cardiovascular events and neonatal transient tachypnea, necrotizing enterocolitis, peri- and intraventricular hemorrhage, and retinopathy of prematurity among deliveries to overweight or obese women.” 

References:

http://journals.lww.com/greenjournal/Abstract/publishahead/Obstetric_and_Neonatal_Risks_Among_Obese_Women.98718.aspx