Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study

Stephen J. McCall; Zhuoyang Li; Jennifer J. Kurinczuk; Elizabeth Sullivan; Marian Knight

doi:10.1371/journal.pone.0211278

Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study

Stephen J. McCall^* (Corresponding Author), Zhuoyang Li, Jennifer J. Kurinczuk, Elizabeth Sullivan, Marian Knight

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

Objective To examine the association between maternal BMI>50kg/m2 during pregnancy and maternal and perinatal outcomes. Materials and methods An international cohort study was conducted using data from separate national studies in the UK and Australia. Outcomes of pregnant women with BMI>50 were compared to those of pregnant women with BMI<50. Multivariable logistic regression estimated the association between BMI>50 and perinatal and maternal outcomes. Results 932 pregnant women with BMI>50 were compared with 1232 pregnant women with BMI<50. Pregnant women with BMI>50 were slightly older, more likely to be multiparous, and have pre-existing comorbidities. There were no maternal deaths, however, extremely obese women had a nine-fold increase in the odds of thrombotic events compared to those with a BMI<50 (uOR: 9.39 (95%CI:1.15–76.43)). After adjustment, a BMI>50 during pregnancy had significantly raised odds of preeclampsia/eclampsia (aOR:4.88(95%CI: 3.11–7.65)), caesarean delivery (aOR: 2.77 (95%CI: 2.31–3.32)), induction of labour (aOR: 2.45(95% CI:2.00–2.99)) post caesarean wound infection (aOR:7.25(95%CI: 3.28–16.07)), macrosomia (aOR: 8.05(95%CI: 4.70–13.78)) compared a BMI<50. Twelve of the infants born to women in the extremely obese cohort died in the early neonatal period or were stillborn. Conclusions Pregnant women with BMI>50 have a high risk of inferior maternal and perinatal outcomes.

Original language	English
Article number	e0211278
Number of pages	11
Journal	PloS ONE
Volume	14
Issue number	2
DOIs	https://doi.org/10.1371/journal.pone.0211278
Publication status	Published - 4 Feb 2019

Data Availability Statement

Data cannot be shared publicly because of because of confidentiality issues. Requests for access to the UK dataset will be considered by the National Perinatal Epidemiology Unit Data Sharing committee. Access to the data can be requested from general@npeu.ox.ac.uk. Access to the Australian data requires an application to the AMOSS steering committee and will require specific ethics committee approval in Australia. Therefore, the terms and conditions of using the Australian data does not give the NPEU the permission to share the Australian data. The authors required approval from the AMOSS steering committee and ethics committee to access the Australian data. The AMOSS committee can be contacted using amoss@uts.edu.au in the first instance.

Keywords

Body mass index
Hypertensive disorders in pregnancy
Pregnancy
Obesity
Medical risk factors
Gestational diabetes
Labor and delivery
Obstetrics and gynecology

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Cite this

@article{43a62b75e1e14d1e91db5f07ea4108e9,

title = "Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study",

abstract = "Objective To examine the association between maternal BMI>50kg/m2 during pregnancy and maternal and perinatal outcomes. Materials and methods An international cohort study was conducted using data from separate national studies in the UK and Australia. Outcomes of pregnant women with BMI>50 were compared to those of pregnant women with BMI<50. Multivariable logistic regression estimated the association between BMI>50 and perinatal and maternal outcomes. Results 932 pregnant women with BMI>50 were compared with 1232 pregnant women with BMI<50. Pregnant women with BMI>50 were slightly older, more likely to be multiparous, and have pre-existing comorbidities. There were no maternal deaths, however, extremely obese women had a nine-fold increase in the odds of thrombotic events compared to those with a BMI<50 (uOR: 9.39 (95%CI:1.15–76.43)). After adjustment, a BMI>50 during pregnancy had significantly raised odds of preeclampsia/eclampsia (aOR:4.88(95%CI: 3.11–7.65)), caesarean delivery (aOR: 2.77 (95%CI: 2.31–3.32)), induction of labour (aOR: 2.45(95% CI:2.00–2.99)) post caesarean wound infection (aOR:7.25(95%CI: 3.28–16.07)), macrosomia (aOR: 8.05(95%CI: 4.70–13.78)) compared a BMI<50. Twelve of the infants born to women in the extremely obese cohort died in the early neonatal period or were stillborn. Conclusions Pregnant women with BMI>50 have a high risk of inferior maternal and perinatal outcomes.",

keywords = "Body mass index, Hypertensive disorders in pregnancy, Pregnancy, Obesity, Medical risk factors, Gestational diabetes, Labor and delivery, Obstetrics and gynecology",

author = "McCall, {Stephen J.} and Zhuoyang Li and Kurinczuk, {Jennifer J.} and Elizabeth Sullivan and Marian Knight",

year = "2019",

month = feb,

day = "4",

doi = "10.1371/journal.pone.0211278",

language = "English",

volume = "14",

journal = "PloS ONE",

issn = "1932-6203",

publisher = "PUBLIC LIBRARY SCIENCE",

number = "2",

}

TY - JOUR

T1 - Maternal and perinatal outcomes in pregnant women with BMI >50

T2 - An international collaborative study

AU - McCall, Stephen J.

AU - Li, Zhuoyang

AU - Kurinczuk, Jennifer J.

AU - Sullivan, Elizabeth

AU - Knight, Marian

PY - 2019/2/4

Y1 - 2019/2/4

N2 - Objective To examine the association between maternal BMI>50kg/m2 during pregnancy and maternal and perinatal outcomes. Materials and methods An international cohort study was conducted using data from separate national studies in the UK and Australia. Outcomes of pregnant women with BMI>50 were compared to those of pregnant women with BMI<50. Multivariable logistic regression estimated the association between BMI>50 and perinatal and maternal outcomes. Results 932 pregnant women with BMI>50 were compared with 1232 pregnant women with BMI<50. Pregnant women with BMI>50 were slightly older, more likely to be multiparous, and have pre-existing comorbidities. There were no maternal deaths, however, extremely obese women had a nine-fold increase in the odds of thrombotic events compared to those with a BMI<50 (uOR: 9.39 (95%CI:1.15–76.43)). After adjustment, a BMI>50 during pregnancy had significantly raised odds of preeclampsia/eclampsia (aOR:4.88(95%CI: 3.11–7.65)), caesarean delivery (aOR: 2.77 (95%CI: 2.31–3.32)), induction of labour (aOR: 2.45(95% CI:2.00–2.99)) post caesarean wound infection (aOR:7.25(95%CI: 3.28–16.07)), macrosomia (aOR: 8.05(95%CI: 4.70–13.78)) compared a BMI<50. Twelve of the infants born to women in the extremely obese cohort died in the early neonatal period or were stillborn. Conclusions Pregnant women with BMI>50 have a high risk of inferior maternal and perinatal outcomes.

AB - Objective To examine the association between maternal BMI>50kg/m2 during pregnancy and maternal and perinatal outcomes. Materials and methods An international cohort study was conducted using data from separate national studies in the UK and Australia. Outcomes of pregnant women with BMI>50 were compared to those of pregnant women with BMI<50. Multivariable logistic regression estimated the association between BMI>50 and perinatal and maternal outcomes. Results 932 pregnant women with BMI>50 were compared with 1232 pregnant women with BMI<50. Pregnant women with BMI>50 were slightly older, more likely to be multiparous, and have pre-existing comorbidities. There were no maternal deaths, however, extremely obese women had a nine-fold increase in the odds of thrombotic events compared to those with a BMI<50 (uOR: 9.39 (95%CI:1.15–76.43)). After adjustment, a BMI>50 during pregnancy had significantly raised odds of preeclampsia/eclampsia (aOR:4.88(95%CI: 3.11–7.65)), caesarean delivery (aOR: 2.77 (95%CI: 2.31–3.32)), induction of labour (aOR: 2.45(95% CI:2.00–2.99)) post caesarean wound infection (aOR:7.25(95%CI: 3.28–16.07)), macrosomia (aOR: 8.05(95%CI: 4.70–13.78)) compared a BMI<50. Twelve of the infants born to women in the extremely obese cohort died in the early neonatal period or were stillborn. Conclusions Pregnant women with BMI>50 have a high risk of inferior maternal and perinatal outcomes.

KW - Body mass index

KW - Hypertensive disorders in pregnancy

KW - Pregnancy

KW - Obesity

KW - Medical risk factors

KW - Gestational diabetes

KW - Labor and delivery

KW - Obstetrics and gynecology

U2 - 10.1371/journal.pone.0211278

DO - 10.1371/journal.pone.0211278

M3 - Article

SN - 1932-6203

VL - 14

JO - PloS ONE

JF - PloS ONE

IS - 2

M1 - e0211278

ER -

Maternal and perinatal outcomes in pregnant women with BMI >50: An international collaborative study

Abstract

Data Availability Statement

Keywords

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