Impact of maternal obesity on very preterm infants
Rubia Khalak1, Asha Rijhsinghani2, Sarah E McCallum3
1Department of Pediatrics/Neonatology Division, Albany Medical Center, Albany, New York, USA.
Insights
Maternal obesity, particularly level III obesity, increases the need for delivery room resuscitation in very preterm infants. This finding highlights potential impacts on intensive care resource utilization for these vulnerable newborns.
Area of Science:
- Neonatalogy
- Maternal-Fetal Medicine
- Public Health
Background:
- Infants born before 34 weeks' gestation face heightened risks of morbidity and mortality.
- Limited data exist on how maternal obesity affects very preterm infants' intensive care requirements.
Purpose of the Study:
- To investigate if maternal obesity exacerbates the intensive care needs of infants born before 34 weeks' gestational age.
Main Methods:
- Retrospective review of maternal and neonatal data for singleton births between 23 0/7 and 33 6/7 weeks' gestation.
- Maternal Body Mass Index (BMI) categorized using NIH classifications, including three ascending obesity levels.
Main Results:
- 31.6% of 1,224 women studied had obesity.
- Infants born to mothers with level III obesity showed significantly higher rates of delivery room (DR) resuscitation (63.2%, P=0.04).
- A trend indicated a continued need for assisted ventilation beyond 6 hours for infants of mothers with level III obesity (54.7%, P=0.06).
Conclusions:
- Very preterm infants born to mothers with level III obesity are more likely to require DR resuscitation.
- There is a trend suggesting these infants may need ongoing ventilatory support, impacting DR resource allocation.
Objective:
Infants born at less than 34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation.
Methods:
Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed. BMI categorization followed the National Institutes of Health BMI classification that subdivides obesity into three ascending BMI groups.
Results:
Records were obtained on 1,224 women, of whom 31.6% were classified with obesity. Despite similar mean gestational age (31 to 31.6 weeks, P = 0.57) and birth weight (1,488 to 1,569 g, P = 0.51) of the infants in the BMI categories, delivery room (DR) resuscitation was more common for infants of women with level III obesity (63.2%, P = 0.04) with a trend toward the continued need for assisted ventilation (54.7%, P = 0.06).
Conclusions:
Preterm infants of women with level III obesity were more likely to require DR resuscitation with a trend to continued need for ventilatory support beyond 6 hours of age. This could impact utilization of DR resources at delivering hospitals.
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