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Am J Perinatol 2009; 26(5): 345-349
DOI: 10.1055/s-0028-1110084
© Thieme Medical Publishers

The Impact of Maternal Obesity on the Incidence of Adverse Pregnancy Outcomes in High-Risk Term Pregnancies

Saju Joy1 , Niki Istwan2 , Debbie Rhea2 , Cheryl Desch2 , Gary Stanziano2
  • 1Wake Forest University, Winston-Salem, North Carolina
  • 2Matria Healthcare, Department of Clinical Research, Marietta, Georgia
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Publication History

Publication Date:
09 December 2008 (online)

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ABSTRACT

We investigated the impact of maternal obesity on pregnancy outcomes. Women with normal or obese body mass index (BMI) who delivered singleton infants at term were identified from a perinatal database. Rates of pregnancy complications and neonatal outcomes were compared between women with normal prepregnancy BMI (20 to 24.9 kg/m2, n = 9171) and those with an obese prepregnancy BMI (≥ 30, n = 3744). Rates of pregnancy complications and neonatal outcomes were also evaluated by the level of obesity (obese [30 to 34.9 kg/m2, n = 2106], severe obesity [35 to 39.9 kg/m2, n = 953], and morbid obesity [≥ 40 kg/m2, n = 685]). Rates of gestational diabetes (12.0% versus 3.7%, p < 0.001, odds ratio [95% confidence interval] = 3.5 [3.0, 4.1]) and gestational hypertension (30.9% versus 9.0%, p < 0.001, odds ratio [95% confidence interval] = 4.5 [4.1, 5.0]) were higher for obese versus normal BMI gravidas, respectively. Women with morbid or severe obesity had a greater incidence of gestational diabetes than women with an obese (30 to 34.9 kg/m2) or normal BMI (14.1%, 16.4%, 9.6%, and 3.7%, respectively; p < 0.05). The incidence of gestational hypertension increased with maternal BMI (9.0% normal, 25.5% obese, 33.7% severe, 43.4% morbid; all pairwise comparisons p < 0.05). Obese versus normal BMI was associated with more higher-level nursery admissions (8.2% versus 5.8%) and large-for-gestational age infants (12.3% versus 6.5%; p < 0.001). Obesity places a term pregnancy at risk for adverse maternal and neonatal outcomes.

KEYWORDS

Maternal obesity - body mass index - pregnancy outcomes - neonatal outcomes

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Saju JoyM.D. M.S. 

Wake Forest University Health Sciences, Department of OB/GYN

Maternal-Fetal Medicine, Medical Center Boulevard, Winston-Salem, NC 27157

Email: sjoy@wfubmc.edu

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