Pregestational body mass index and risk of maternal adverse events

In women of reproductive age, pregestational overweight and/or obesity could result in negative outcomes for both, mother and child.

To investigate the association between pregestational body mass index (PBMI) and maternal adverse outcomes (MAO) during childbirth, in women assisted during 2014, in a public hospital in Mérida, Yucatán, Mexico.

427 pregnant women assisted during childbirth were consecutively included, identifying among them those who did not have any MAO (n = 137), whose demographic and clinical data, including PBMI, were compared with those who did have at least one MAO (n = 290). Odds ratios (OR) and 95% confidence intervals (95% CI) were obtained using a binary logistic regression model (LRM).

33% had normal PBMI, and 37% had obesity. Urgent cesarean section was the most frequent MAO (58.8%). According to the LRM, schooling (secondary school level, OR: 0.56; 95% CI: 0.34-0.94), primigravidae ( OR: 6.88; 95% CI: 3.37-12.58), and secondigravidae women (OR: 5.57; 95% CI: 3.04-10.24), the number of prenatal visits (≥ 5, OR: 3.49; 95% CI: 1.54-7.91), and PBMI (overweight, OR: 0.41: 95% CI: 0.23-0.72) were identified as clinically and statistically significant.

Women with overweight were at low risk for MAO, while schooling (secondary school level) reduced risk by 44%, being a primigravidae or a secondigravidae increased risk more than 6 and 5 times, respectively. Paradoxically, prenatal visits (≥ 5 medical visits) increased risk more than 3 times.