Maternal outcomes in pregnancies complicated by obesity

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Reproductive Medicine

Background:

• Prepregnancy obesity is a growing concern in maternal health.
• Understanding its impact on pregnancy outcomes is crucial for clinical practice and public health initiatives.

Purpose of the Study:

• To investigate the association between prepregnancy obesity and various adverse maternal outcomes.
• To quantify the increased risks associated with different levels of maternal obesity.

Main Methods:

• A 15-year population-based cohort study utilizing the Nova Scotia Atlee Perinatal Database.
• Comparison of maternal outcomes between obese (weight > 90 kg) and nonobese women, with obesity further categorized into moderate (90-120 kg) and severe (> 120 kg) groups.
• Statistical analysis using univariate and multivariable logistic regression to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).

Main Results:

• Obesity affected 7.2% of 142,404 singleton pregnancies, with a rising trend observed between 1988 and 2002.
• Moderately obese women showed increased risks for pregnancy-induced hypertension (PIH) (aOR 2.38), antepartum venous thromboembolism (aOR 2.17), labor induction (aOR 1.94), cesarean delivery (aOR 1.60), and wound infection (aOR 1.67).
• Severely obese women faced even higher risks: PIH (aOR 3.00), antepartum venous thromboembolism (aOR 4.13), labor induction (aOR 2.77), cesarean delivery (aOR 2.46), anesthesia complications (aOR 2.01), and wound infection (aOR 4.79).

Conclusions:

• Prepregnancy maternal obesity is a significant risk factor for adverse maternal outcomes.
• Specific risks include pregnancy-induced hypertension, antepartum venous thromboembolism, labor induction, cesarean delivery, and wound infection.
• The study underscores the need for interventions addressing prepregnancy obesity to mitigate these risks.