scholarly journals Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study

2019 ◽  
Vol 47 (6) ◽  
pp. 625-630 ◽  
Author(s):  
Iñigo Melchor ◽  
Jorge Burgos ◽  
Ana del Campo ◽  
Amaia Aiartzaguena ◽  
Julieta Gutiérrez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Maternal Obesity ◽  
Perinatal Outcomes ◽  
Normal Weight ◽  
World Health ◽  
Obese Women ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Adverse Pregnancy

Abstract Background Obesity in pregnancy is increasing worldwide, reaching epidemic proportions in many countries and frequently creating challenges for obstetricians. We conducted this study to assess the effects of maternal obesity on maternal and perinatal outcomes. Methods A historical cohort study was performed on 16,609 women who delivered singleton babies in a 5-year period (2013–2017). Data were retrieved from the Cruces Perinatal Database (CPD) and only women whose prepregnancy body mass index (BMI) was known were included. Women were categorized according to the World Health Organization (WHO) classification: normal weight (BMI 20–24.9 kg/m2) and obesity (BMI ≥ 30 kg/m2). Obstetric, perinatal and neonatal outcomes were compared, and adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were calculated using the normal-weight group as the reference. Results Compared to women of normal weight (n = 9778), obese women (n = 2207) had a higher risk of preeclampsia (aOR 2.199, 95% CI: 1.46–3.29), rectovaginal group B streptococcus colonization (aOR 1.299, 95% CI: 1.14–1.47), induction of labor (aOR 1.593, 95% CI: 1.44–1.75), cesarean section (aOR 2.755, 95% CI: 2.46–3.08), cesarean section in women with a history of cesarean delivery (aOR 1.409, 95% CI: 1.03–1.92), fetal weight ≥4000 g (aOR 2.090, 95% CI: 1.803–2.422) and admission to the neonatal intensive care unit (NICU) (aOR 1.341, 95% CI: 1.12–1.59). No association was found with preterm birth (aOR 0.936, 95% CI: 0.77–1.13), stillbirth (aOR 0.921, 95% CI: 0.41–2.02) or neonatal mortality (aOR 2.205, 95% CI: 0.86–5.62). Conclusion Maternal obesity is associated with a higher risk of adverse pregnancy and perinatal outcomes. Pregnancy in this population of women should be considered and managed as high risk.

scholarly journals Group B Streptococcus (GBS) Colonization and Disease among Pregnant Women: A Historical Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
James M. Edwards ◽  
Nora Watson ◽  
Chris Focht ◽  
Clara Wynn ◽  
Christopher A. Todd ◽  
...  
Keyword(s):  
Cohort Study ◽  
Group B Streptococcus ◽  
Perinatal Outcomes ◽  
Chronic Hypertension ◽  
Short Cervix ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Group B

Background. Maternal GBS colonization is associated with early-onset neonatal sepsis and extensive efforts are directed to preventing this complication. Less is known about maternal risks of GBS colonization. We seek to provide a modern estimate of the incidence and impact of maternal GBS colonization and invasive GBS disease. Methods. A single center historical cohort study of all births between 2003 and 2015 was performed. Data was collected via electronic health record abstraction using an institutional specific tool. Descriptive statistics were performed regarding GBS status. Inferential statistics were performed comparing risk of adverse pregnancy outcomes in cohorts with and without GBS colonization as well as cohorts with GBS colonization and invasive GBS disease. Results. A total of 60,029 deliveries were included for analysis. Overall, 21.6% of the population was GBS colonized and 0.1% had invasive GBS disease. GBS colonization was associated with younger maternal age, Black race, non-Hispanic ethnicity, chronic hypertension, preexisting diabetes, and tobacco use (p<0.01). In the adjusted analyses, there was an increased risk of gestational diabetes (aRR 1.21, 95% CI 1.11-1.32) in colonized pregnancies and a decreased incidence of short cervix (aRR 0.64, 95% CI 0.52-0.79), chorioamnionitis (aRR 0.76, 95% CI 0.66-0.87), wound infection (aRR 0.75, 95% CI 0.64-0.88), and operative delivery (aRR 0.85, 95% CI 0.83-0.88). Conclusions. This modern-day large cohort of all births over a 12-year period demonstrates a GBS colonization rate of 21.6%. This data reflects a need to assess maternal and perinatal outcomes in addition to neonatal GBS sepsis rates to inform decisions regarding the utility of maternal vaccination.

Comparison of perinatal outcomes between long-term and short-term use of tocolytic agent: a historical cohort study in a single perinatal hospital

2016 ◽  
Vol 42 (12) ◽  
pp. 1680-1685 ◽  
Author(s):  
Masamitsu Nakamura ◽  
Junichi Hasegawa ◽  
Tatsuya Arakaki ◽  
Shoko Hamada ◽  
Hiroko Takita ◽  
...  
Keyword(s):  
Cohort Study ◽  
Perinatal Outcomes ◽  
Short Term ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Tocolytic Agent

scholarly journals Impact of nicotine and maternal BMI on fetal birth weight

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Veronika Günther ◽  
Ibrahim Alkatout ◽  
Christoph Vollmer ◽  
Nicolai Maass ◽  
Alexander Strauss ◽  
...  
Keyword(s):  
Birth Weight ◽  
Smoking Status ◽  
Statistical Significance ◽  
Perinatal Outcomes ◽  
Normal Weight ◽  
World Health ◽  
Smoking During Pregnancy ◽  
Adverse Pregnancy ◽  
Health Organization ◽  
Maternal Bmi

Abstract Background According to the World Health Organization, smoking is the most important risk factor for adverse pregnancy outcomes in industrialized nations. As the individual factors (body mass index – BMI (kg/m2) – and cigarette consumption) have been extensively investigated in pregnancy, we aimed to establish how maternal BMI and nicotine interact with regard to perinatal outcomes and birth weight. Methods Data from 110.047 singleton pregnancies, achieved from the German Perinatal Survey in Schleswig-Holstein and registered between 2010 and 2017 were analyzed in August 2018 concerning maternal BMI and smoking. The BMI was taken from the maternity log. Information concerning the smoking status were self-reported and further subdivided into the following four categories: a) non-smokers; b) 1–7 cigarettes/day; c) 8–14 cigarettes/ day; and d) ≥ 15 cigarettes/ day. Furthermore, we classified women by their BMI into underweight, normal weight, overweight and obese. Comparisons between non-smokers and the respective smoking group, and their relationship with maternal BMI were performed by the t-test (birth weight). A P-value ≤0.05 was considered to indicate statistical significance. Results A number of 97.092 women (88.2%) were non-smokers and 12.955 (11.8%) were smokers. Furthermore 10.3% of women of normal weight smoked during pregnancy, but both high and low BMI were associated with a high prevalence of smoking. The proportion of smokers was highest (18.1%) among underweight women (BMI ≤ 18.5 kg/m2). A large number of smokers (15.5%) were registered in the obesity group (BMI ≥ 30 kg/m2). Mean birth weight (≥ 37 + 0 gestational age) increased with increasing maternal BMI, and was reduced by smoking for every BMI category. The differences between smokers and non-smokers were always highly significant (p < 0.001). Mean birth weight varied between 2995 g in underweight frequent smokers and 3607 g in obese non-smokers. Conclusion Both maternal BMI and smoking during pregnancy influences the birth weight and therefore pregnancy outcome. Smoking during pregnancy was significantly associated with low birth weight. Pregnant women should be advised to cease or at least reduce smoking in order to improve the birth weight of the newborn and to minimize child morbidities.

scholarly journals Implications of Early Pregnancy Obesity on Maternal, Fetal and Neonatal Health: Retrospective cohort study from Oman

2018 ◽  
Vol 18 (1) ◽  
pp. 47 ◽  
Author(s):  
Anita Zutshi ◽  
Jayasree Santhosh ◽  
Julie Sheikh ◽  
Fareeha Naeem ◽  
Ahmed Al-Hamedi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Early Pregnancy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Normal Weight ◽  
World Health ◽  
Obstetric Outcomes ◽  
Obese Women ◽  
Neonatal Complications ◽  
Increased Risk

Objectives: This study aimed to determine the prevalence of early pregnancy obesity among Omani women and to review maternal antenatal complications, intrapartum and postpartum events and neonatal complications among such women in comparison to women of normal weight. Methods: This retrospective cohort study included 2,652 pregnant Omani women who delivered at the Royal Hospital, Muscat, Oman, between November 2011 and April 2012. The patients’ electronic medical records were reviewed for antenatal, intrapartum and postpartum data. Body mass index was measured during the first trimester (≤12 gestational weeks) and classified according to the World Health Organization categories. Maternal and neonatal complications were compared between obese women and those of normal weight. Obstetric outcomes in uncomplicated pregnancies were also compared. Results: In the study cohort, there were 901 (34%) obese women and 912 (34.4%) women of normal weight; of these, 440 (48.8%) and 672 (73.7%) had uncomplicated pregnancies, respectively. Obese women had a significantly increased incidence of gestational diabetes (relative risk [RR]: 2.23; 95% confidence interval [CI]: 1.70–2.92; P <0.01), gestational hypertension (RR: 3.04; 95% CI: 1.63–5.65; P <0.01), Caesarean delivery (RR: 1.48; 95% CI: 1.08–2.03; P <0.01), postpartum haemorrhage (RR: 2.10; 95% CI: 1.11–4.10; P = 0.01) and fetal macrosomia (RR: 2.71; 95% CI: 1.21–6.09; P <0.01). Conclusion: Approximately one-third of the studied Omani women were obese. These women had a significantly increased risk of various maternal antenatal complications, intrapartum and postpartum events and neonatal complications.

scholarly journals Effect of Premature Rupture of Membranes on Induction of Labor: A Historical Cohort Study

2017 ◽  
Vol 77 (11) ◽  
pp. 1174-1181 ◽  
Author(s):  
Sven Kehl ◽  
Christel Weiss ◽  
Ulf Dammer ◽  
Friederike Baier ◽  
Florian Faschingbauer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Induction Of Labor ◽  
Cesarean Section Rate ◽  
Chromosomal Anomalies ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
The Impact

Abstract Objective The aim of this study was to assess the influence of premature rupture of membranes (PROM) on the induction of labor. Material and Method This historical cohort study analyzed 1861 inductions of labor at term using misoprostol which occurred between 2010 and 2015. Exclusion criteria included intrauterine fetal death, previous cesarean section, and fetal structural or chromosomal anomalies. Induction of labor for PROM (PROM group) was compared to induction for other indications (no-PROM group); the primary outcome measure was the cesarean section rate. Results The cesarean section rate for the PROM group was significantly lower (21.9% vs. 26.3%, p = 0.029). The induction-to-delivery interval was shorter (mean: 972 [854 – 6734] min vs. 1741 [97 – 10 834] min, p < 0.0001) and the rates of vaginal birth within 24 hours (80.9 vs. 52.0%, p = 0.0001) and 48 hours (98.4 vs. 85.3%, p = 0.0001) were higher in the PROM group. The impact of PROM on the cesarean section rate was not significant in multivariate analysis; however, PROM was found to have the greatest effect on the induction-to-delivery interval (p < 0.0001). Conclusion Premature rupture of membranes significantly affects various outcome measures when delivery is induced, particularly the induction-to-delivery interval.

scholarly journals Association between Maternal Obesity Class, Adherence to Labor Guidelines, and Perinatal Outcomes

2021 ◽  
Vol 11 (02) ◽  
pp. e105-e112
Author(s):  
Irene A. Stafford ◽  
Ahmed S.Z. Moustafa ◽  
Lauren Spoo ◽  
Alexandra Berra ◽  
Angela Burgess ◽  
...  
Keyword(s):  
Guideline Adherence ◽  
Maternal Obesity ◽  
Perinatal Outcomes ◽  
Normal Weight ◽  
Obese Women ◽  
Class Iii ◽  
Perinatal Complications ◽  
Obesity Class ◽  
Class Iii Obesity ◽  
Primary Cesarean Delivery

Abstract Background Data are limited concerning rates of perinatal complications in women with a body mass index (BMI) ≥40 kg/m2 compared to women with other BMI classes when guidelines for the safe prevention of the primary cesarean delivery are applied. Objective The aim of the study is to evaluate labor guideline adherence by BMI class and to compare perinatal outcomes across BMI classes with guideline adherent management. Study Design This retrospective study included low-risk women admitted for delivery between April 2014 and April 2017 after the labor guidelines were implemented. BMI closest to delivery was used for analysis. Women with cesarean for nonreassuring fetal status were excluded. Results Guideline adherence decreased with increasing BMI, with 93% adherence among women of normal weight compared to 81% for class III obese women (p < 0.0001). Among women who had guideline-adherent management, there was increased rates of cesarean among class III versus other obesity classes; however, there were no differences in rates of infectious morbidity (p = 0.98) or hemorrhage (p = 0.93). Although newborns of women with class III obesity had higher rates of meconium at birth, neonatal outcomes were not different with increasing maternal BMI (p = 0.65). Conclusion There were no differences in adverse perinatal outcomes with increasing BMI.

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