The effect of the increasing prevalence of maternal obesity on perinatal morbidity

Am J Obstet Gynecol. 2001 Oct;185(4):845-9. doi: 10.1067/mob.2001.117351.


Objective: In this study, we assessed the temporal trends and relative and attributable perinatal risks of maternal obesity over a 20-year period.

Study design: We conducted a retrospective cohort study between 1980 and 1999 by using a computerized perinatal database of all women who received prenatal care and delivered their infants within a regional health care system. The main outcome measures were as follows: (1) annual mean body weight and the percentage of women classified as obese at the first prenatal visit (primary definition > or = 200 lb; secondary definitions > or = 250 lb, > or = 300 lb, body mass index > 29 kg/m(2)); and (2) relative and attributable risks of obesity for selected maternal and perinatal morbidities in successive 5-year periods.

Results: From 1980 to 1999, the mean maternal weight of women at the first prenatal visit increased 20% (144-172 lb), as did the percentage of women > or = 200 lb (7.3-24.4), the percentage > or = 250 lb (1.9-10.7), the percentage > or = 300 lb (0.5-4.9), and the percentage with a body mass index > 29 kg/m(2) (16.3-36.4), P < .01 for all. Controlling for maternal age, race, and smoking status, obese women were at increased risk at each period for cesarean delivery (range of adjusted relative risk, 1.5-1.8), gestational diabetes (range, 1.8-2.9), and large (> 90th percentile) for gestational age infants (range, 1.8-2.2). From the earliest 5-year period (1980-1984) to the most recent (1995-1999), the percentage of obesity-attributable cesarean deliveries more than tripled from 3.9 to 11.6. Similar percentage increases were observed for the obesity-attributable risks for gestational diabetes (12.8-29.6) and large for gestational age infants (6.5-19.1). Trends for secondary obesity definitions were similar, although the magnitude of the increased attributable risks was smaller.

Conclusions: Efforts to reduce the frequency of certain perinatal morbidities will be constrained unless effective measures to prevent, or limit the risks of, maternal obesity are developed and implemented.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Body Weight
  • Cesarean Section / statistics & numerical data
  • Cohort Studies
  • Comorbidity
  • Confidence Intervals
  • Female
  • Fetal Diseases / epidemiology*
  • Gestational Age
  • Humans
  • Infant Mortality / trends*
  • Infant, Newborn
  • Obesity / epidemiology*
  • Obstetric Labor Complications / diagnosis
  • Obstetric Labor Complications / epidemiology
  • Pregnancy
  • Pregnancy Outcome*
  • Prevalence
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors