Obesity and Pregnant Women Outcomes

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BMC Public Health
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Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies Sohinee Bhattacharya*1, Doris M Campbell2, William A Liston3 and Siladitya Bhattacharya2 Address: 1Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, Aberdeen, AB25 2ZD, UK, 2Department of Obstetrics & Gynaecology, Aberdeen Maternity Hospital, Foresterhill, Aberdeen, AB25 2ZD, UK and 3The Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh – Little France, Edinburgh, EH16 4SA, UK Email: Sohinee Bhattacharya* - sohinee.bhattacharya@abdn.ac.uk; Doris M Campbell - d.m.campbell@abdn.ac.uk; William A Liston - Liston@btinternet.com; Siladitya Bhattacharya - s.bhattacharya@abdn.ac.uk * Corresponding author

Published: 24 July 2007 BMC Public Health 2007, 7:168 doi:10.1186/1471-2458-7-168

Received: 15 March 2007 Accepted: 24 July 2007

This article is available from: http://www.biomedcentral.com/1471-2458/7/168 © 2007 Bhattacharya et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Background: The increasing prevalence of obesity in young women is a major public health concern. These trends have a major impact on pregnancy outcomes in these women, which have been documented by several researchers. In a population based cohort study, using routinely collected data, this paper examines the effect of increasing Body Mass Index (BMI) on pregnancy outcomes in nulliparous women delivering singleton babies. Methods: This was a retrospective cohort study, based on all nulliparous women delivering singleton babies in Aberdeen between 1976 and 2005. Women were categorized into five groups – underweight (BMI < 20 Kg/m2), normal (BMI 20 – 24.9 Kg/m2) overweight (BMI 25 – 29.9 Kg/m2), obese (BMI 30 – 34.9 Kg/m2) and morbidly obese (BMI > 35 Kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. Results: In comparison with women of BMI 20 – 24.9, morbidly obese women faced the highest risk of pre-eclampsia {OR 7.2 (95% CI 4.7, 11.2)} and underweight women the lowest {OR 0.6 (95% CI 0.5, 0.7)}. Induced labour was highest in the morbidly obese {OR 1.8 (95% CI 1.3, 2.5)} and lowest in underweight women {OR 0.8 (95% CI 0.8, 0.9)}. Emergency Caesarean section rates were highest in the morbidly obese {OR 2.8 (95% CI 2.0, 3.9)}, and comparable in women with normal and low BMI. Obese women were more likely to have postpartum haemorrhage {OR 1.5 (95% CI 1.3, 1.7)} and preterm delivery (< 33 weeks) {OR 2.0 (95% CI 1.3, 2.9)}. Birthweights less than 2,500 g were more common in underweight women {OR 1.7 (95% OR 1.2, 2.0)}. The highest risk of birth weights > 4,000 g was in the morbidly obese {OR 2.1 (95% CI 1.3, 3.2)} and the lowest in underweight women {OR 0.5 (95% CI 0.4, 0.6)}. Conclusion: Increasing BMI is associated with increased incidence of pre-eclampsia, gestational hypertension, macrosomia, induction of labour and caesarean delivery; while underweight women had better pregnancy outcomes than women with normal BMI.

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BMC Public Health 2007, 7:168

http://www.biomedcentral.com/1471-2458/7/168

Background
The rising rate of obesity is a major public health concern in the West, where 28% of pregnant women are overweight and 11% are obese [1]. In the United States, the incidence of obesity in pregnancy varies from 18.5% to 38.3% according to the definition used [2-5]. In the UK, 56% of all women are over the recommended BMI, with 33% of them classified as overweight (BMI > 25) and 23% obese (BMI > 30). Although the exact incidence of obesity in pregnant women in the...
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