Composite neonatal and maternal morbidities with small- versus appropriate- for gestational age among uncomplicated obese women undergoing repeat cesarean delivery*
Autor: | Susan Hosseini Nasab, Hind N. Moussa, Ziad A. Haidar, Janice E. Whitty, Bahaeddine M Sibai, Oscar A. Viteri |
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Rok vydání: | 2017 |
Předmět: |
Adult
medicine.medical_specialty Infant Newborn Diseases Body Mass Index 03 medical and health sciences Postoperative Complications 0302 clinical medicine Pregnancy Risk Factors medicine Coagulopathy Humans Cesarean Section Repeat Obesity Prospective Studies Registries 030212 general & internal medicine Prospective cohort study Retrospective Studies 030219 obstetrics & reproductive medicine Respiratory distress Obstetrics business.industry Infant Newborn Obstetrics and Gynecology Retrospective cohort study medicine.disease Pregnancy Complications Intraventricular hemorrhage Case-Control Studies Infant Small for Gestational Age Pediatrics Perinatology and Child Health Necrotizing enterocolitis Small for gestational age Female business |
Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 32:562-567 |
ISSN: | 1476-4954 1476-7058 |
Popis: | Our goal was to compare composite neonatal and maternal morbidities (composite neonatal morbidity (CNM), composite maternal morbidity (CMM)) among deliveries with small for age (SGA) versus appropriate for gestational age (AGA; birthweight 10-89%) among obese versus non-obese women undergoing repeat cesarean delivery (CD).This is a secondary analysis of a prospective observational study. Women who had elective CD ≥37 weeks were studied. We excluded multiple gestations, fetal anomalies, 1 prior CD, and medical diseases. Patients were divided into BMI ≥30 versus30 kg/mOf 7561 women, we included 65% were obese and 35% were not. SGA rates differed significantly: 8 versus 12% (p .001). Overall, CNM was significantly higher in patients with SGA versus AGA (adjusted odds ratio (aOR) 2.04, 95% CI 1.19-3.49). CMM of SGA in obese versus non-obese was statistically different (aOR 0.11, 95% CI 0.02-0.68). Among obese mothers, SGA neonates had significantly higher CNM compared with AGA ones (aOR 2.17, 95% CI 1.03-4.59).SGA occurred in 8% of low-risk obese women with prior CD. CNM of SGA babies in obese versus non-obese women were similar. Paradoxically, CMM was lower in obese cases, possibly reflecting the caution that obese patients receive preoperatively. Our findings may assist in counseling patients and designing trials. |
Databáze: | OpenAIRE |
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