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
A2 - Luo, Zhong-Cheng
N1 - Funding: SJM is funded by the Nuffield Department of Population Health and Medical Research Council (MRC) training grant MR/K501256/1. MK is funded by an NIHR Research Professorship. The views expressed in this publication are those of the author(s), and not necessarily those of the MRC, the NHIR or the Department of Health. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the article. The National Health and Medical Research Council Project Grant (application 510298) for funding The Australian Maternity Outcomes Surveillance System: Improving safety and quality of maternity care in Australia (AMOSS) from 2008–2012.
Data Availability: 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.
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.
U2 - 10.1371/journal.pone.0211278
DO - 10.1371/journal.pone.0211278
M3 - Article
VL - 14
JO - PloS ONE
JF - PloS ONE
SN - 1932-6203
IS - 2
M1 - e0211278
ER -