The incidence and impact of increased body mass index on maternal and fetal morbidity in the low-risk primigravid population

Sarkar, Rupak; Cooley, Sharon; Donnelly, Jennifer; Walsh, Thomas A.; Collins, Claire; Geary, Michael

doi:10.1080/14767050701713090

Cited by 29 publications

(20 citation statements)

References 13 publications

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“…Second, most studies have grouped patients with a BMI > 30 kg/m 2 into one category. (8,9,13,17-19) Given the large number of obese patients in our database we were able to give detailed risks of cesarean deliveries within the different obesity classes. This is important given the linear relationship between BMI and cesarean and the BMI population trends in the United States.…”

Section: Commentmentioning

confidence: 99%

The maternal body mass index: a strong association with delivery route

Kominiarek¹,

VanVeldhuisen²,

Hibbard³

et al. 2010

American Journal of Obstetrics and Gynecology

146

121

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Objective-To assess body mass index (BMI) effect on cesarean risk during labor.Study Design-The Consortium on Safe Labor collected electronic data from 228,668 deliveries. Women with singletons ≥37 weeks and known BMI at labor admission were analyzed in this cohort study. Regression analysis generated relative risks for cesarean stratifying for parity and prior cesarean while controlling for covariates Results-Of the 124,389 women, 14.0% had cesareans. Cesareans increased with increasing BMI for nulliparas, multiparas with and without a prior cesarean. Repeat cesareans were performed in >50% of laboring women with a BMI >40kg/m 2 . The risk for cesarean increased as BMI increased for all subgroups, p<0.001. The risk for cesarean increased by 5%, 2%, and 5% for nulliparas, multiparas with and without a prior cesarean, respectively, for each 1kg/m 2 rise in BMI.Conclusion-Admission BMI is significantly associated with delivery route in term laboring women. Parity and prior cesarean are other important predictors.

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Section: Commentmentioning

confidence: 99%

The maternal body mass index: a strong association with delivery route

Kominiarek¹,

VanVeldhuisen²,

Hibbard³

et al. 2010

American Journal of Obstetrics and Gynecology

146

121

View full text Add to dashboard Cite

show abstract

“…However, investigations of intrapartum intervention use in obese women have had conflicting results. Two prospective cohort studies conducted prior to the Abenhaim study did not find evidence of increased epidural usage by obese women, and investigators of several studies have not found there is decreased use of assisted vaginal birth among obese women …”

Section: Introductionmentioning

confidence: 98%

Intrapartum Management Associated with Obesity in Nulliparous Women

Carlson¹,

Lowe²

2014

J Midwife Womens Health

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Future studies examining the intrapartum management of obese nulliparous women are needed with: 1) samples defined by standardized obesity classifications; 2) further analysis of diverse intrapartum interventions; and 3) prospective, randomized designs to allow for causality conclusions linking intrapartum intervention use to an obese woman's risk for cesarean birth. Implications for clinical practice from this systematic review are that healthy, nulliparous obese women are exposed to common intrapartum interventions more often than normal-weight women. In the absence of evidence on the use of appropriate use of intrapartum interventions in this population, health care providers should carefully monitor management choices when working with healthy, nulliparous obese women.

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“…By assessing the eff ect of these parameters on the placenta, it is hoped to gain a better understanding of the pathogenesis of vascular abnormalities, which can occur in placental insuffi ciency. Th is was done as part of a large prospective observational population study on the prevalence of inherited and acquired thrombophilia in a low-risk nulliparous population, focusing on maternal, fetal and placental outcome; some of the results of which have been published elsewhere (Cooley et al 2011a,b;Donnelly et al 2008;Sarkar et al 2007). …”

Section: Introductionmentioning

confidence: 99%

Circulating pro- and anticoagulant levels in normal and complicated primigravid pregnancies and their relationship to placental pathology

Donnelly

Cooley

Walsh

et al. 2013

Journal of Obstetrics and Gynaecology

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We aimed to compare the changes in factor VIII:C, antithrombin, protein C, protein S and fibrinogen in a cohort of low-risk primigravida who developed maternal or fetal complications to those who had uncomplicated pregnancies and to correlate these findings with placental pathology. This is a case-control study of 170 cases and 122 controls selected from a prospective cohort of 1,011 low-risk primigravida. Significantly elevated levels of factor VIII:C and significantly decreased levels of antithrombin were seen in women who developed pre-eclampsia (p <0.001), placental infarction (p < 0.001) or had infants with a birth weight < 3rd centile (p < 0.001). Placental villous dysmaturity was significantly associated with raised factor VIII:C (p < 0.001). Women who developed pre-eclampsia showed elevated fibrinogen at 14 weeks (p = 0.03). Significantly higher than normal pregnancy levels of factor VIII:C, in tandem with significantly lower antithrombin levels associated with certain adverse pregnancy outcomes, may be related to underlying placental insufficiency. This is supported by associated placental findings.

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The incidence and impact of increased body mass index on maternal and fetal morbidity in the low-risk primigravid population

Abstract: High BMI is associated with longer gestations, higher operative delivery rates, and an increased rate of neonatal intensive care admission

Cited by 29 publications

References 13 publications

The maternal body mass index: a strong association with delivery route

The maternal body mass index: a strong association with delivery route

Intrapartum Management Associated with Obesity in Nulliparous Women

Circulating pro- and anticoagulant levels in normal and complicated primigravid pregnancies and their relationship to placental pathology

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