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Analysis

Impact of obesity in obstetrics_2

9 June, 2008

Impact of obesity in obstetrics_2

In Brisbane,Australia, researchers explored the prevalence of overweight and obese pregnant women, with the aim of assessing the associated maternal, peripartum and neonatal outcomes.
 

Callaway L, Prins J, Chang A, McIntyre D. (2006) The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Austr 184: 56-9.


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Midwives magazine: May 2006

 

In Brisbane,Australia, researchers explored the prevalence of overweight and obese pregnant women, with the aim of assessing the associated maternal, peripartum and neonatal outcomes.

 

Data from a hospital-specific database was reviewed. Information was collected by the midwife at the first antenatal visit, usually before 12 weeks of pregnancy. Data for 11 252 pregnant women who delivered between January 1998 and December 2002 and had a singleton pregnancy were reviewed. The women were categorised as normal (body mass index (BMI) 20.01 to 25kg/sq m), overweight (BMI 25.01 to 30kg/sq m), obese (BMI 30.01 to 40kg/sq m) or morbidly obese (BMI >40kg/sq m). There were 4171 women who had no BMI recorded – they were systematically different from those who had, with poorer levels of education and more likely to be of Aboriginal or Torres Strait Islander descent or belong to other minority ethnic groups. They had significantly increased rates of hypertensive disorders of pregnancy, caesarean section (CS) and neonatal complications.

 

Of those who had their BMI recorded, 2882 (20.2%) were overweight, 1679 (11.8%) were obese and 248 (1.7%) were morbidly obese. Higher BMI was associated with increased maternal age, parity and cigarette smoking. The overall prevalence of gestational diabetes was 2% in this study, with increased rates for those with obesity. Increasing BMI was associated with reduced rates of spontaneous and assisted vaginal delivery and increased rates of CS, as well as higher birthweight, rates of admission for intensive care, birth defects, respiratory distress syndrome, hypoglycaemia and prematurity.

 

Risks of hypertensive disorders of pregnancy, gestational diabetes, maternal hospital admission for more than five days and CS rose with increasing BMI. In the morbidly obese group, the risk of delivery before 34 weeks was higher and there was a significant association with neonatal jaundice. The study, which provides information on all births in Queensland over the study period, confirms that overweight and obesity are common in this obstetric population, highlighting an important public health issue.

 

There were significant baseline differences between women who did and did not have BMI recorded antenatally – the authors believe BMI should be recorded routinely for all pregnant women to assist in planning health service delivery.

 


 

 

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