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The risk of adverse pregnancy outcomes in women who are overweight or obese.

Abstract

BACKGROUND

The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes.

METHODS

A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS). Women were categorized into three groups according to their body mass index (BMI): normal (BMI 18.5-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2) and; obese (BMI 30-34.9 kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses.

RESULTS

Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR) 2.99 [95% confidence intervals (CI) 1.88, 4.73], p < 0.0001) and gestational diabetes (RR 2.10 [95%CI 1.17, 3.79], p = 0.01) compared with women with a normal BMI. Obese and overweight women were more likely to be induced and require a caesarean section compared with women of normal BMI (induction - RR 1.33 [95%CI 1.13, 1.57], p = 0.001 and 1.78 [95%CI 1.51, 2.09], p < 0.0001, caesarean section - RR 1.42 [95%CI 1.18, 1.70], p = 0.0002 and 1.63 [95%CI 1.34, 1.99], p < 0.0001). Babies of women who were obese were more likely to be large for gestational age (LFGA) (RR 2.08 [95%CI 1.47, 2.93], p < 0.0001) and macrosomic (RR 4.54 [95%CI 2.01, 10.24], p = 0.0003) compared with those of women with a normal BMI.

CONCLUSION

The rate of overweight and obesity is increasing amongst the Australian obstetric population. Women who are overweight and obese have an increased risk of adverse pregnancy outcomes. In particular, obese women are at increased risk of gestational diabetes, pregnancy induced hypertension and pre-eclampsia. Effective preventative strategies are urgently needed.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN00416244.

Authors+Show Affiliations

Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide 5005, South Australia. chaturica.athukorala@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20849609

Citation

Athukorala, Chaturica, et al. "The Risk of Adverse Pregnancy Outcomes in Women Who Are Overweight or Obese." BMC Pregnancy and Childbirth, vol. 10, 2010, p. 56.
Athukorala C, Rumbold AR, Willson KJ, et al. The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy Childbirth. 2010;10:56.
Athukorala, C., Rumbold, A. R., Willson, K. J., & Crowther, C. A. (2010). The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy and Childbirth, 10, p. 56. doi:10.1186/1471-2393-10-56.
Athukorala C, et al. The Risk of Adverse Pregnancy Outcomes in Women Who Are Overweight or Obese. BMC Pregnancy Childbirth. 2010 Sep 17;10:56. PubMed PMID: 20849609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The risk of adverse pregnancy outcomes in women who are overweight or obese. AU - Athukorala,Chaturica, AU - Rumbold,Alice R, AU - Willson,Kristyn J, AU - Crowther,Caroline A, Y1 - 2010/09/17/ PY - 2010/04/24/received PY - 2010/09/17/accepted PY - 2010/9/21/entrez PY - 2010/9/21/pubmed PY - 2011/1/15/medline SP - 56 EP - 56 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 10 N2 - BACKGROUND: The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes. METHODS: A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS). Women were categorized into three groups according to their body mass index (BMI): normal (BMI 18.5-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2) and; obese (BMI 30-34.9 kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. RESULTS: Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR) 2.99 [95% confidence intervals (CI) 1.88, 4.73], p < 0.0001) and gestational diabetes (RR 2.10 [95%CI 1.17, 3.79], p = 0.01) compared with women with a normal BMI. Obese and overweight women were more likely to be induced and require a caesarean section compared with women of normal BMI (induction - RR 1.33 [95%CI 1.13, 1.57], p = 0.001 and 1.78 [95%CI 1.51, 2.09], p < 0.0001, caesarean section - RR 1.42 [95%CI 1.18, 1.70], p = 0.0002 and 1.63 [95%CI 1.34, 1.99], p < 0.0001). Babies of women who were obese were more likely to be large for gestational age (LFGA) (RR 2.08 [95%CI 1.47, 2.93], p < 0.0001) and macrosomic (RR 4.54 [95%CI 2.01, 10.24], p = 0.0003) compared with those of women with a normal BMI. CONCLUSION: The rate of overweight and obesity is increasing amongst the Australian obstetric population. Women who are overweight and obese have an increased risk of adverse pregnancy outcomes. In particular, obese women are at increased risk of gestational diabetes, pregnancy induced hypertension and pre-eclampsia. Effective preventative strategies are urgently needed. TRIAL REGISTRATION: Current Controlled Trials ISRCTN00416244. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/20849609/The_risk_of_adverse_pregnancy_outcomes_in_women_who_are_overweight_or_obese_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-10-56 DB - PRIME DP - Unbound Medicine ER -