Maternal morbid obesity and obstetric outcomes

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Public Health

Background:

• Morbid obesity, defined as a Body Mass Index (BMI) ≥40.0 kg/m², poses significant risks during pregnancy.
• Understanding pregnancy outcomes in this population is crucial for improving maternal and infant health.
• European tertiary referral centers manage a growing number of pregnancies complicated by severe obesity.

Purpose of the Study:

• To review pregnancy outcomes in morbidly obese women delivering infants ≥500g.
• To identify the incidence of medical complications and obstetric interventions in this cohort.
• To inform the development of specialized antenatal services and pre-pregnancy interventions.

Main Methods:

• Retrospective cohort study including 5,824 women delivering infants ≥500g.
• Morbid obesity defined by WHO criteria (BMI ≥40.0 kg/m²) at the first antenatal visit.
• Obstetric outcomes extracted from a hospital computerized database.

Main Results:

• The incidence of morbid obesity was 0.6% (35 out of 5,824 women).
• Morbidly obese women were older and more likely to be multigravidas.
• High rates of complications (hypertension 35.8%, diabetes mellitus 20.0%) and interventions (induction 42.1%, caesarean section 45.3%) were observed.

Conclusions:

• Maternal morbid obesity is linked to a high incidence of medical complications and increased obstetric interventions.
• Specialized antenatal services for morbidly obese women should be considered.
• The effectiveness of pre-pregnancy interventions for this group requires evaluation.