Characteristics associated with uncomplicated pregnancies in women with obesity: a population-based cohort study

Autor: Matias C. Vieira, Alysha L J Harvey, Dharmintra Pasupathy, Daniel J. Corsi, Laura Gaudet, Yanfang Guo, Sophie Relph
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Comorbidity
Body Mass Index
Low-risk
0302 clinical medicine
Pregnancy
Uncomplicated
Medicine
030212 general & internal medicine
Prospective cohort study
2. Zero hunger
Ontario
education.field_of_study
030219 obstetrics & reproductive medicine
Obstetrics
Pregnancy Outcome
Obstetrics and Gynecology
Gestational age
Gestational diabetes
Parity
Perinatal Care
Birth Certificates
Premature Birth
Female
Cohort study
Research Article
Adult
medicine.medical_specialty
Registry
Maternity
Population
Reproductive medicine
Gestational Age
Risk Assessment
lcsh:Gynecology and obstetrics
03 medical and health sciences
Humans
Antenatal
Maternal Health Services
Obesity
education
lcsh:RG1-991
business.industry
Infant
Newborn
medicine.disease
Pregnancy Complications
Pregnancy Trimester
First
business
Body mass index
Zdroj: BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-10 (2021)
BMC Pregnancy and Childbirth
ISSN: 1471-2393
Popis: Background Approximately one in five pregnant women have obesity. Obesity is associated with an increased risk of antenatal, intrapartum, and perinatal complications, but many women with obesity have uncomplicated pregnancies. At a time where maternity services are advocating for women to make informed choices, knowledge of the chance of having an uncomplicated (healthy) pregnancy is essential. The objective of this study was to calculate the rate of uncomplicated pregnancy in women with obesity and evaluate factors associated with this outcome. Methods This prospective cohort study was conducted using the Ontario birth registry dataset in Canada (703,115 women, April 2012–March 2017). The rate of uncomplicated or complicated composite pregnancy outcomes (hypertensive disorders of pregnancy, gestational diabetes, preterm birth, neonate small- or large- for gestational age at birth, congenital anomaly, fetal death, antepartum bleeding or preterm prelabour membrane rupture) were calculated for women with and without obesity. Associations between uncomplicated pregnancy and maternal characteristics were explored in a population of women with obesity but without other pre-existing co-morbidities (e.g., essential hypertension) or obstetric risks identified in the first trimester (e.g., multiple pregnancy), using log binomial regression analysis. Results Of the studied Ontario maternity population (body mass index not missing) 17·7% (n = 117,236) were obese. Of these 20·6% had pre-existing co-morbidities or early obstetric complicating factors. Amongst women with obesity but without early complicating factors, 58·2% (n = 54,191) experienced pregnancy without complication; this is in comparison to 72·7% of women of healthy weight and no early complicating factors. Women with obesity and no early pregnancy complicating factors are more likely to have an uncomplicated pregnancy if they are multiparous, younger, more affluent, of White or Black ethnicity, of lower weight, with normal placental-associated plasma protein-A and/or spontaneously conceived pregnancies. Conclusions The study demonstrates that over half of women with obesity but no other pre-existing medical or early obstetric complicating factors, proceed through pregnancy without adverse obstetric complication. Care in lower-risk settings can be considered as their outcomes appear similar to those reported for low-risk nulliparous women. Further research and predictive tools are needed to inform stratification of women with obesity.
Databáze: OpenAIRE
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