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Erschienen in:

01.10.2011 | Materno-fetal Medicine

Pregnancy, obesity, gestational weight gain, and parity as predictors of peripartum complications

verfasst von: Everett F. Magann, Dorota A. Doherty, Suneet P. Chauhan, Jennifer M. Klimpel, Shannon D. Huff, John C. Morrison

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2011

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Abstract

Purpose

To determine if the best predictor of pregnancy complications is pre-pregnancy body mass index (BMI) alone or in combination with other factors.

Methods

BMI and peripartum outcomes of singleton pregnancies were evaluated. Recursive partitioning and logistic regression modeling was used.

Results

Of the 4,286 cohorts, 26% were obese (BMI >30 kg/m²) and, compared to cohorts with normal weight, at risk for wound infections (P < 0.001), and shoulder dystocia (P < 0.001). High-risk patients (15%; BMI >32.5, parity, pregnancy weight gain of 28 lb by 28 weeks) were at increased risk for wound infection (P < 0.001), endometritis (P < 0.001), shoulder dystocia (P = 0.001) and 5 min Apgar score <4 (P < 0.041) and at lower risk for pre-term delivery (P = 0.007).

Conclusions

Since BMI, parity, and weight gain until 28 weeks together provide better prediction of peripartum complications than BMI alone, these characteristics can be used to triage and refer patients.

Ehrenberg HM, Dierker L, Milluzzi C, Mercer BM (2002) Prevalence of maternal obesity in an urban center. Am J Obstet Gynecol 187:1189–1193PubMedCrossRef

Isaacs JD, Magann EF, Martin RW, Chauhan SP, Morrison JC (1994) Obstetric challenges of massive obesity complicating pregnancy. J Perinatol 14:10–14PubMed

Galtier-Dereure F, Boegner C, Bringer J (2000) Obesity and pregnancy. Am J Clin Nutr 71:1242–1248

Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, Regan L, Robinson L (2001) Maternal obesity and pregnancy outcome: a study of 287, 213 pregnancies in London. Int J Obes 25:1175–1182CrossRef

Crane SS, Wojtowycz MA, Dye TD, Aubry RH, Artal R (1997) Association between pre-pregnancy obesity and the risk of cesarean delivery. Obstet Gynecol 89:213–216PubMedCrossRef

Johnson SR, Kolberg BH, Varner MW, Railsback LD (1987) Maternal obesity and pregnancy. Surg Gynecol Obstet 164:431–437PubMed

Bianco AT, Smilen SW, Davis Y, Lopez S, Lapinski R, Lockwood CJ (1998) Pregnancy outcome and weight gain recommendations for the morbidly obese. Obstet Gynecol 91:97–102PubMedCrossRef

Kliegman RM, Gross T (1985) Perinatal problems of the obese mother and her infant. Am J Obstet Gynecol 66:299–305

Rasmussen SA, Chu SY, Kim SY, Schmid CH (2008) Maternal obesity and risk of neural tube defects: a metaanalysis. Am J Obstet Gynecol 198:611–619PubMedCrossRef

10.

Chu SY, Kim SY, Lau J, Schmid CH, Dietz PM, Callaghan WM, Curtis KM (2007) Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol 197:223–228PubMedCrossRef

11.

Salihu HM, Dunlop AL, Hedayatzadeh M, Alio AP, Kirby RS, Alexander GR (2007) Extreme obesity and risk of stillbirth among black and white gravidas. Obstet Gynecol 110:552–557PubMedCrossRef

12.

Cnattingius S, Bergstrom R, Lipworth L, Krammer MS (1998) Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 338:147–152PubMedCrossRef

13.

Cedergren MI (2004) Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 103:219–224PubMedCrossRef

14.

Viswanathan M, Siega-Riz AM, Moos MK, Deieriein A, Mumford S, Knaack J, Thieda P, Lux JL, Lohr KN (2008) Outcomes of maternal weight gain. Evid Rep Technol Assess 168:1–223

15.

Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M (1996) A United States national reference for fetal growth. Obstet Gynecol 87:163–168PubMedCrossRef

16.

Rasmussen KM, Yaktine AL (eds) (2009) Weight gain during pregnancy: reexamining the guidelines. Institute of Medicine (US) and National Research Council (US) Committee to reexamine IOM pregnancy weight guidelines. National Academies Press (US), Washington DC

17.

Schrauwers C, Decker G (2009) Maternal and perinatal outcome in obese pregnant patients. J Matern Fetal Neonat Med 22:218–226CrossRef

18.

Rode L, Nilas L, Wojdemann K, Tabor A (2005) Obesity related complications in Danish single cephalic term pregnancies. Obstet Gynecol 105:537–542PubMedCrossRef

19.

Bergholt T, Lim LK, Jorgensen JS, Robson MS (2007) Maternal body mass index in the first trimester and risk of cesarean delivery in nulliparous women in spontaneous labor. Am J Obstet Gynecol 196:163.e1–163.e5CrossRef

20.

Chu SY, Bachman DJ, Callaghan WM, Whitlock EP, Dietz PM, Berg CJ, O’Keeffe-Rosetti M, Bruce C, Hornbrook MC (2008) Association between obesity during pregnancy and increased use of health care. N Engl J Med 358:1444–1453PubMedCrossRef

21.

DeVadar SR, Neeley HL, Myles TD, Leet TL (2007) Evaluation of gestational weight gain guidelines for women with normal prepregnancy body mass index. Obstet Gynecol 110:745–751CrossRef

Titel: Pregnancy, obesity, gestational weight gain, and parity as predictors of peripartum complications
verfasst von: Everett F. Magann
Dorota A. Doherty
Suneet P. Chauhan
Jennifer M. Klimpel
Shannon D. Huff
John C. Morrison
Publikationsdatum: 01.10.2011
Verlag: Springer-Verlag
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 4/2011
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-010-1754-0

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Pregnancy, obesity, gestational weight gain, and parity as predictors of peripartum complications