Obese Women

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Very Obese Women Have More Pregnancy Complications

By Amy Norton

NEW YORK (Reuters Health) - Women who are extremely obese early in
pregnancy face higher rates of complications that put them and their babies
at risk, a large study suggests.

The study, which looked at more than 800,000 women who gave birth in Sweden
between 1992 and 2001, found that morbidly obese women had increased risks
of several complications during pregnancy and delivery.

Moreover, compared with normal-weight women, their babies were two to three
times more likely to be stillborn or to die soon after birth, although
these outcomes were uncommon regardless of the mother's weight.

Study author Dr. Marie Cedergren of Linkoping University told Reuters
Health that the findings should motivate young women to gain control over
their weight before planning their first pregnancy.

She reports the results in the February issue of the journal Obstetrics &
Gynecology.

Depending on the definition used, morbid obesity refers to a body mass
index (BMI) of either 35 or higher, or 40 or higher. That amounts to being
about 100 pounds or more above one's ideal weight.

It has been shown that obese women -- those whose BMIs are 30 or higher --
face greater odds of pregnancy complications like high blood pressure and
diabetes in the mother, as well as stillbirth and cesarean delivery. But it
has been unclear whether the risks are even greater for morbidly obese
women.

According to Cedergren, no past studies have looked at such a large group
of morbidly obese pregnant women. Her research included more than 16,000
women with a BMI of at least 35, and among whom 3,480 had a BMI of 40 or
higher.

Overall, these women had four to five times the risk of normal-weight women
of developing pre-eclampsia, a condition marked by high blood pressure and
other problems that can lead to the life-threatening disorder eclampsia.

They were also two to three times more likely to suffer a stillbirth after
the 28th week of pregnancy, and were more than twice as likely to need a
cesarean section or to have labor induced.

Cedergren also found that the babies of morbidly obese women were more
likely to die shortly after birth, compared with those born to
normal-weight women. These infants also had higher rates of fetal distress,
high birth weight, and low Apgar scores -- a measure of newborn health that
includes heart rate, breathing and other factors.

Women who were obese also tended to have higher complication rates than
normal-weight women, but those who were morbidly obese were most at risk.

"Pregnancies among morbidly obese women must be classified as high-risk
pregnancies," Cedergren concludes in the report, "and appropriate
(prenatal) care should be provided."


SOURCE: Obstetrics & Gynecology, February 2004

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