Obesity not always risky in pregnancy

Wednesday September 11th, 2013

Obese women who have already had a baby, and have no additional risk factors, are at low risk of pregnancy complications, researchers say today.

Obesity is a significant risk factor for many pregnancy and birth complications such as including gestational diabetes, miscarriage, stillbirth, caesarean and instrumental delivery.

So according to current guidelines, all obese women should be advised to give birth in an obstetric unit, in order to reduce the risks of adverse outcomes.

But Dr Jennifer Hollowell, of Oxford University, UK, and her team questioned this recommendation.

They used figures on 17,230 women without any medical or obstetric risk factors other than obesity (body mass index of 30 or above).

They found that obesity was linked to a higher risk of interventions, but the number of times a woman has previously given birth was a much stronger indicator of risk.

Surprisingly, the results suggest that healthy first-time mothers of normal weight are more likely to need obstetric intervention than healthy obese women with at least one previous birth.

The risks of adverse foetal outcomes - including admissions to a neonatal unit, intrapartum stillbirth and early neonatal death - were much lower for obese low-risk women who had previously had a baby than for first-time mothers.

Details are published today (11 September) in BJOG: An International Journal of Obstetrics and Gynaecology.

Dr Hollowell said: "Our results showed that obese women who have previously had a baby and who do not have additional risk factors such as diabetes or a previous caesarean section, may have lower obstetric risks than previously appreciated. These findings suggest that it may be reasonable to allow some multiparous obese women, who are otherwise healthy, a choice of birth setting."

Louise Silverton, of the UK Royal College of Midwives, said: "Not all pregnancies are planned and midwives encourage mothers to manage their weight during pregnancy.

"For those mothers who are overweight or obese, there is a need to avoid excess weight gain and for those of normal weight to maintain this status."

Hollowell, J. et al. The impact of maternal obesity on intrapartum outcomes in otherwise low risk women: secondary analysis of the Birthplace national prospective cohort study. BJOG 11 September 2013; doi: 10.1111/1471-0528.12437

Tags: Childbirth and Pregnancy | Diet & Food | Fitness | Nursing & Midwifery | UK News | Women's Health & Gynaecology

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