Obesity Weighs Down Pregnancy Outcomes

Obese mothers at higher risk for post delivery intensive care and lower infant health

(RxWiki News) Being overweight can be a burden for an expectant mother. When it comes to labor and delivery, that extra weight can cause certain complications for both the mother and child.

A recent study evaluated the relation between obesity and newborn health with regards to social, medical and hospital characteristics and type of labor and delivery.

Intensive care after delivery and low infant health were more common in the obese women than women who were not obese.

The odds of an infant needing intensive care after delivery was increased by about 38 percent if the mother was obese.

"Discuss your weight with a doctor when planning a pregnancy."

Anne-Frederique Minsart from the Université libre de Bruxelles in Brussels, Belgium and colleagues examined 38,475 births that took place in 2009 from the Belgian birth register. The anonymous and publicly available health register contains all live births and stillbirths from 500 grams or 22 weeks gestation.

The researchers calculated the rates of admission to the intensive care unit after birth, health of the newborn child as defined by the Apgar test and mortality around the time of birth.

The Apgar test is a simple and repeatable way to assess the health of a newborn baby. The infant is evaluated on appearance, pulse, grimace, activity and respiration using a scale from zero to ten.

Higher scores on the Apgar test represent a healthier baby. Low scores may mean that the infant needs medical attention.

A woman in the study was considered obese if she had a body mass index (BMI) of more than 30 kg per meter squared. Obese women accounted for 12.6 percent of births in the study.

The study found that non-cesarean infants born to obese women had roughly a 31 percent higher chance of a low Apgar test score than those born to non-obese mothers.

Obese women who had a cesarean section had roughly a 18 percent greater risk of the need for after birth intensive care and roughly a 50 percent greater risk for a low Apgar score.

The reason for an increased risk of labor and delivery complications in obese women is not known. The authors speculated that it could be due to increased maternal pelvic soft tissue, difficulty estimating fetal weight, difficulty monitoring the fetus and contractions or cardiovascular problems.

Jennifer Mushtaler, MD, an obstetrician in Austin, Texas and a dailyRx Contributing Expert noted that obesity has been repeatedly linked to poorer outcomes for both the mother and the child.

"There are higher rates of gestational diabetes, gestational hypertension, pre-eclampsia, growth restricted infants and cesarean sections," said Dr. Mushtaler in regards to obese mothers-to-be.

"The best way to improve outcomes is to achieve a healthier weight and lifestyle prior to conception," added Dr. Mushtaler.

The study was published in BMC Pregnancy and Childbirth.

Funding was provided by a personal research grant from the National Fund for Scientific Research in Belgium.

The authors reported no conflicts of interest.

Review Date: 
February 21, 2013