Risks of pregnancy and birth in obese primiparous women: an analysis of German perinatal statistics
To compare risks of pregnancy and birth in obese (body mass index, BMI ≥ 30) and normal weight women (BMI 18.5–24.99) giving birth to their first child.
We analysed data of 243,571 pregnancies in primiparous women from the German perinatal statistics of 1998–2000. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) for selected pregnancy and birth risks. ORs were adjusted for the confounding factors age, smoking status, single mother status, and maternal education.
Obesity during pregnancy is common in primiparous women (n = 19,130; 7.9% of all cases) and it is significantly associated with a number of risks of pregnancy and birth, including diabetes [OR 3.71 (95% CI 2.93; 4.71); p < 0.001], hypertension [OR 8.44 (7.91; 9.00); p < 0.001], preecalmpsia/eclampsia [OR 6.72 (6.30; 7.17); p < 0.001], intraamniotic infection [OR 2.33 (2.05; 2.64); p < 0.001], birth weight ≥4,000 g [OR 2.16 (2.05; 2.28); p < 0.001], and an increased rate of Caesarean section [OR 2.23 (2.15; 2.30); p < 0.001]. Some risks were less frequent in the obese such as cervical incompetence [OR 0.55 (0.48; 0.63); p < 0.001] and preterm labour [OR 0.47 (0.43; 0.51); p < 0.001].
Obesity during pregnancy is an important clinical problem in primiparous women because it is common and it is associated with a number of risks of pregnancy and birth. Because of these increased risks, obese women need special attention clinically during the course of their first pregnancy. Weight reduction before the first pregnancy is generally indicated in obese women to prevent the above-mentioned complications of pregnancy and birth.
- Hauner H, Bramlage P, Lösch C et al (2008) Prevalence of obesity in primary care using different anthropometric measures–results of the German Metabolic and Cardiovascular Risk Project (GEMCAS). BMC Public Health 8:282 CrossRef
- Vahratian A (2009) Prevalence of overweight and obesity among women of childbearing age: results from the 2002 National Survey of Family Growth. Matern Child Health J 13:268–273 CrossRef
- Sebire NJ, Jolly M, Harris JP (2001) Maternal obesity and pregnancy outcome: a study of 287, 213 pregnancies in London. Int J Obes Relat Metab Disord 25:1175–1182 CrossRef
- Voigt M, Straube S, Zygmunt M et al (2008) Obesity and pregnancy–a risk profile. Z Geburtshilfe Neonatol 212:201–205 CrossRef
- Voigt M, Zygmunt M, Henrich W et al (2008) Analysis of subgroup of pregnant women in Germany. 16th communication: morbid obesity: pregnancy risks, birth risks and status of the newborn. Geburtsh Frauenheilk 68:794–800 CrossRef
- Gale CR, Javaid MK, Robinson SM et al (2007) Maternal size in pregnancy and body composition in children. J Clin Endocr Metab 92:3904–3911 CrossRef
- Bhattacharya S, Campbell DM, Liston WA et al (2007) Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 7:168–176 CrossRef
- Smith GC, Shah I, Pell JP et al (2007) Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: a retrospective cohort study. Am J Public Health 97:157–162 CrossRef
- Dietz PM, Callaghan WM, Morrow B et al (2005) Population-based assessment of the risk of primary cesarean delivery due to excess prepregnancy weight among nulliparous women delivering term infants. Matern Child Health J 9:237–244 CrossRef
- Vahratian A, Siega-Riz AM, Savitz DA et al (2005) Maternal pre-pregancy overweight and obesity and the risk of caesarean delivery in nulliparous women. Ann Epidemiol 15:467–474 CrossRef
- Weiss JL, Malone FD, Emig D et al (2004) Obesity, obstetric complications and cesarean delivery rate–a population-based screening study. Am J Obstet Gynec 190:1091–1097 CrossRef
- Dempsey JC, Ashiny Z, Qiu CF et al (2005) Maternal pre-pregnancy overweight status and obesity as risk factors for cesarean delivery. J Matern Fetal Neonatal Med 17:179–185 CrossRef
- Sheiner E, Levy A, Menes TS et al (2004) Maternal obesity as an independent risk factor for caesarean delivery. Paediatr Perinat Epidemiol 18:196–201 CrossRef
- Burstein E, Levy A, Mazor M et al (2008) Pregnancy outcome among obese women: a prospective study. Am J Perinatol 25:561–566 CrossRef
- Jaddoe VW, Troe EJ, Hofman A et al (2008) Active and passive maternal smoking during pregnancy and the risks of low birthweight and preterm birth: the Generation R Study. Paediatr Perinat Epidemiol 22:162–171 CrossRef
- Risks of pregnancy and birth in obese primiparous women: an analysis of German perinatal statistics
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Archives of Gynecology and Obstetrics
Volume 283, Issue 2 , pp 249-253
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- 1. Department of Obstetrics and Gynaecology, University of Rostock, Rostock, Germany
- 2. Institute for Perinatal Auxology, Klinikum Südstadt, Rostock, Germany
- 3. Department of Obstetrics and Gynaecology, University Hospital Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland
- 4. Research Institute for the Biology of Farm Animals (FBN), Research Unit Genetics and Biometry, Dummerstorf, Germany
- 5. Department of Occupational and Social Medicine, University of Göttingen, Göttingen, Germany