Assessing the Role of Maternal Prepregnancy Body Mass Index and Obesity in Neonatal Outcomes [38]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 125 Suppl 1; no. Supplement 1; p. 21S
• Main Authors: Schneider, Jason Andrew, Spiryda, Lisa Beth
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.05.2015
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000465323.18195.77

INTRODUCTION:Prepregnancy obesity is associated with complications including preeclampsia, gestational diabetes mellitus, stillbirth, and fetal macrosomia. The objective of this study was to determine whether prepregnancy body mass index (BMI, calculated as weight (kg)/[height (m)]) affected immediate neonatal outcomes. METHODS:Institutional review board–exempt status was obtained. Medical information was abstracted from all deliveries at University of Florida Health in December 2013, including age, race–ethnicity, prepregnancy and postpregnancy BMI, total maternal weight gain, mode of delivery, Apgar scores, and cord gas pH level. Standard statistical analysis was performed with Microsoft Excel; null hypothesis was rejected for P<.05. RESULTS:A total of 135 patient charts were reviewed; average age was 27.5 year, mean prepregnancy BMI was 28.7, and average gestational weight gain was 12.55 kg. Thirty-nine percent of patients were normal-weight or underweight, 25% were overweight, and 36% were obese. Average fetal weight at delivery was 3,375 g. Fetal weight incrementally increased as maternal BMI increased; women with normal or low BMIs had an average fetal weight of 3,299 g, whereas those who were obese had an average fetal weight of 3,490 g. Apgar score at 1 minute was significantly lower for neonates of mothers with class III obesity than for those of mothers with normal or low BMIs (7 compared with 8.3; P=.04). The venous cord gases showed that patients with class II and III obesity had significantly lower pH levels than did normal-weight or underweight patients (7.3 and 7.28, respectively, compared with 7.34; P=.02 and .01). CONCLUSION:Prepregnancy obesity can lead to high fetal weight, lower 1 minute Apgar scores, and lower venous cord gas pH levels. We aim to analyze data based on gestational weight gain as well as to collect more patient charts to increase study power.