Perinatal outcome in pregnancy complicated by massive obesity

Jordan H. Perlow, Mark A. Morgan, Douglas Montgomery, Craig Towers, Manuel Porto

Research output: Contribution to journalArticle

131 Citations (Scopus)

Abstract

OBJECTIVE: Our objective was to determine the impact of massive obesity during pregnancy, defined as maternal weight >300 pounds, on perinatal outcome. STUDY DESIGN: A case-controlled study was conducted. Between Jan. 1, 1986, and Dec. 31, 1990, 111 pregnant women weighing >300 pounds who were delivered at Long Beach Memorial Women's Hospital were identified with a perinatal data base search. A control group matched for maternal age and parity was selected, and perinatal variables were compared between groups. To control for potential confounding medical complications, massively obese patients with diabetes and/or chronic hypertension antedating the index pregnancy were excluded from the obese group, and the data were reanalyzed. The Student t test x2, and Fisher's exact statistical analysis were used where appropriate. RESULTS: Massively obese pregnant women are significantly more likely to have a multitude of adverse perinatal outcomes, including primary cesarean section (32.4% vs 14.3%, p = 0.002), macrosomia (30.2% vs 11.6%, pp = 0.0001), intrauterine growth retardation (8.1% vs 0.9%, p = 0.03), and neonatal admission to the intensive care unit (15.6% vs 4.5%, p = 0.01). They also are significantly more likely to have chronic hypertension (27.0% vs 0.9%, p < 0.0001) and insulin-dependent diabetes mellitus (19.8% vs 2.7%, p = 0.0001). However, when those massively obese pregnant women with diabetes and/or hypertension antedating pregnancy are excluded from analysis, no statistically significant differences in perinatal outcome persisted. CONCLUSION: Massively obese pregnant women are at high risk for adverse perinatal outcome; however, this risk appears to be related to medical complications of obesity. (Am J Obstet Gynecol 1992;167:958–62.)

Original languageEnglish (US)
Pages (from-to)958-962
Number of pages5
JournalAmerican Journal of Obstetrics and Gynecology
Volume167
Issue number4
DOIs
StatePublished - Jan 1 1992

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Pregnancy Outcome
Pregnant Women
Obesity
Hypertension
Pregnancy
Fetal Growth Retardation
Maternal Age
Parity
Type 1 Diabetes Mellitus
Cesarean Section
Intensive Care Units
Mothers
Databases
Students
Weights and Measures
Control Groups

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Perinatal outcome in pregnancy complicated by massive obesity. / Perlow, Jordan H.; Morgan, Mark A.; Montgomery, Douglas; Towers, Craig; Porto, Manuel.

In: American Journal of Obstetrics and Gynecology, Vol. 167, No. 4, 01.01.1992, p. 958-962.

Research output: Contribution to journalArticle

Perlow, Jordan H. ; Morgan, Mark A. ; Montgomery, Douglas ; Towers, Craig ; Porto, Manuel. / Perinatal outcome in pregnancy complicated by massive obesity. In: American Journal of Obstetrics and Gynecology. 1992 ; Vol. 167, No. 4. pp. 958-962.
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AB - OBJECTIVE: Our objective was to determine the impact of massive obesity during pregnancy, defined as maternal weight >300 pounds, on perinatal outcome. STUDY DESIGN: A case-controlled study was conducted. Between Jan. 1, 1986, and Dec. 31, 1990, 111 pregnant women weighing >300 pounds who were delivered at Long Beach Memorial Women's Hospital were identified with a perinatal data base search. A control group matched for maternal age and parity was selected, and perinatal variables were compared between groups. To control for potential confounding medical complications, massively obese patients with diabetes and/or chronic hypertension antedating the index pregnancy were excluded from the obese group, and the data were reanalyzed. The Student t test x2, and Fisher's exact statistical analysis were used where appropriate. RESULTS: Massively obese pregnant women are significantly more likely to have a multitude of adverse perinatal outcomes, including primary cesarean section (32.4% vs 14.3%, p = 0.002), macrosomia (30.2% vs 11.6%, pp = 0.0001), intrauterine growth retardation (8.1% vs 0.9%, p = 0.03), and neonatal admission to the intensive care unit (15.6% vs 4.5%, p = 0.01). They also are significantly more likely to have chronic hypertension (27.0% vs 0.9%, p < 0.0001) and insulin-dependent diabetes mellitus (19.8% vs 2.7%, p = 0.0001). However, when those massively obese pregnant women with diabetes and/or hypertension antedating pregnancy are excluded from analysis, no statistically significant differences in perinatal outcome persisted. CONCLUSION: Massively obese pregnant women are at high risk for adverse perinatal outcome; however, this risk appears to be related to medical complications of obesity. (Am J Obstet Gynecol 1992;167:958–62.)

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