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. 2017 Jul;39(7):330-336.
doi: 10.1055/s-0037-1603826. Epub 2017 Jun 23.

Effect of Obesity on Gestational and Perinatal Outcomes

Sônia Regina Cabral Madi  1 , Rosa Maria Rahmi Garcia  2 , Vandrea Carla de Souza  3 , Renato Luís Rombaldi  1 , Breno Fauth de Araújo  1 , José Mauro Madi  1
Affiliations

Effect of Obesity on Gestational and Perinatal Outcomes

Sônia Regina Cabral Madi et al. Rev Bras Ginecol Obstet. 2017 Jul.

Abstract
in English, Portuguese

Purpose To assess the impact of pre-pregnancy obesity (body mass index [BMI] ≥ 30 kg/m2) on the gestational and perinatal outcomes. Methods Retrospective cohort study of 731 pregnant women with a BMI ≥ 30 kg/m2 at the first prenatal care visit, comparing them with 3,161 women with a BMI between 18.5 kg/m2 and 24.9 kg/m2. Maternal and neonatal variables were assessed. Statistical analyses reporting the demographic features of the pregnant women (obese and normal) were performed with descriptive statistics followed by two-sided independent Student's t tests for the continuous variables, and the chi-squared (χ2) test, or Fisher's exact test, for the categorical variables. We performed a multiple linear regression analysis of newborn body weight based on the mother's BMI, adjusted by maternal age, hyperglycemic disorders, hypertensive disorders, and cesarean deliveries to analyze the relationships among these variables. All analyses were performed with the R (R Foundation for Statistical Computing, Vienna, Austria) for Windows software, version 3.1.0. A value of p < 0.05 was considered statistically significant. Results Obesity was associated with older age [OR 9.8 (7.8-12.2); p < 0.01], hyperglycemic disorders [OR 6.5 (4.8-8.9); p < 0.01], hypertensive disorders [OR 7.6 (6.1-9.5); p < 0.01], caesarean deliveries [OR 2.5 (2.1-3.0); p < 0.01], fetal macrosomia [OR 2.9 (2.3-3.6); p < 0.01] and umbilical cord pH [OR 2.1 (1.4-2.9); p < 0.01). Conversely, no association was observed with the duration of labor, bleeding during labor, Apgar scores at 1 and 5 minutes after birth, gestational age, stillbirth and early neonatal mortality, congenital malformations, and maternal and fetal injury. Conclusion We observed that pre-pregnancy obesity was associated with maternal age, hyperglycemic disorders, hypertension syndrome, cesarean deliveries, fetal macrosomia, and fetal acidosis.

Objetivo Avaliar o impacto da obesidade pré-gestacional (índice de massa corpórea [IMC] ≥ 30 kg/m2) sobre os resultados gestacionais e perinatais. Métodos Estudo transversal retrospectivo, com 731 gestantes que apresentaram IMC ≥ 30 kg/m2 na primeira consulta de pré-natal, comparando-as a 3.161 gestantes com IMC entre 18,5 kg/m2 e 24,9 kg/m2. Foram avaliadas variáveis maternas e neonatais. A análise estatística baseou-se nas características demográficas das gestantes (obesas e com peso normal), e foi realizada com estatísticas descritivas seguidas de testes t de Student independentes bicaudais para variáveis contínuas, e teste de qui-quadrado (χ2) ou exato de Fisher para as variáveis categóricas. Foi realizada uma regressão linear múltipla do peso do recém-nascido sobre o IMC materno, ajustado por idade materna, síndromes hiperglicêmicas, síndromes hipertensivas hipertensivas e operações cesarianas, a fim de analisar a relação entre essas variáveis. Todas as análises foram realizadas com o uso de R (R Foundation for Statistical Computing, Viena, Áustria) para Windows, versão 3.1.0. Um valor de p < 0,05 foi considerado estatisticamente significante. Resultados A obesidade associou-se à idade materna [OR 9,8 (7,8–12,2); p < 0,01], distúrbios hiperglicêmicos [OR 6.5 (4,8–8,9); p < 0,01], distúrbios hipertensivos (RP: 7,6 [6,1–9,5]; p < 0,01), maior taxa de operação cesariana [OR 2,5 (2,1–3,0); p < 0,01], macrossomia fetal [OR 2,9 (2,3–3,6); p < 0,01] e baixo pH na artéria umbilical [OR 2,1 (1,4–2,9); p < 0,01]. Não foi observada associação com tempo de trabalho de parto, sangramento durante o trabalho de parto, índice de Apgar no 1° e 5° minutos, idade gestacional, natimortalidade e mortalidade neonatal precoce, malformações congênitas e tocotraumatismo materno e fetal. Conclusões O estudo mostrou que a obesidade pré-gestacional associou-se com idade materna mais elevada, distúrbios hiperglicêmicos e hipertensivos, taxas mais altas de operação cesariana, macrossomia e acidose fetal.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Fig. 1
Fig. 1
The flow of the selected population through the study. Notes:*Underweight: BMI < 18.5 kg/m2; normal weight: BMI between 18.5 kg/m2 and 24.9 kg/m2; overweight: BMI between 25 kg/m2 and 29.9 kg/m2; obesity grades 1, 2, and 3: BMI ≥ 30 kg/m2.
See this image and copyright information in PMC

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