JOURNAL ARTICLE

The impact of increasing obesity class on obstetrical outcomes

Darine El-Chaar, Sara A Finkelstein, Xiaowen Tu, Deshayne B Fell, Laura Gaudet, Jacques Sylvain, George Tawagi, Shi Wu Wen, Mark Walker
Journal of Obstetrics and Gynaecology Canada: JOGC 2013, 35 (3): 224-233
23470110

OBJECTIVE: Nationally, rates of obesity continue to rise, resulting in increased health concerns for women of reproductive age. Identifying the impact of maternal obesity on obstetrical outcomes is important to enhance patient care.

METHODS: We conducted a retrospective cohort study of 6674 women who delivered a singleton infant at ≥ 20 weeks' gestation between December 1, 2007, and March 31, 2010, at The Ottawa Hospital. Maternal pre-pregnancy BMI was used to classify women into normal, overweight, and obese (class I/II/III) categories according to WHO classifications. Obstetrical outcomes among obese women were compared with those of women with normal BMI. Multivariable regression models were used to determine adjusted odds ratios and 95% confidence intervals.

RESULTS: Compared with women with normal BMI, obese women had significantly higher rates of preeclampsia, gestational hypertension, and gestational diabetes, and these rates increased with increasing BMI (trend-test P < 0.001). There was a significant increase in rates of induction of labour in the obesity categories, from 25.3% in women with normal BMI to 42.9% in women with class III morbid obesity (aOR 1.67; 95% CI 1.43 to 1.93). Rates of primary Caesarean section rose with increasing BMI and were highest in women with class III morbid obesity (36.2% vs. 22.1% in women with normal BMI) (aOR 1.46; 95% CI 1.23 to 1.73).

CONCLUSION: Increasing BMI is associated with increasing rates of preeclampsia, gestational hypertension, and gestational diabetes. There is a significant increase in rates of induction of labour with increasing obesity class, and a significantly increased Caesarean section rate with higher BMI. Obstetrical care providers should counsel obese patients about the risks they face and the importance of weight loss before pregnancy.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23470110
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"