Maternal "isolated" obesity and obstetric complications.

OBJECTIVE

To investigate pregnancy outcomes, particularly cesarean delivery (CD), among women with "isolated" obesity (i.e. without additional comorbidities).

STUDY DESIGN

We conducted a retrospective population-based study between the years 1988-2010. The pregnancy outcomes of obese (prepregnancy BMI ≥30 kg/m(2)) and nonobese patients were compared. Patients with chronic hypertension, pregestational diabetes mellitus, other preexisting chronic morbidities, multiple gestations, age above 40 years, grand multiparity (above 5 deliveries), lack of prenatal care, and following fertility treatments were excluded from the analysis. Stratified analyses, using multiple logistic regression models, were performed to control for confounders.

RESULTS

During the study period, a total of 173,628 deliveries met the inclusion criteria; 1605 (0.9%) occurred in patients with "isolated" obesity. Higher rates of CD were found among patients with "isolated" obesity (30.7% vs. 12.3%; odds ration [OR] = 3.2; p < 0.001). When controlling for possible confounders, using a multivariable model with CD as the outcome variable, the association between "isolated" obesity and CD remained significant (adjusted OR = 2.6; p < 0.001). No significant differences were found in the risks of perinatal complications including perinatal mortality, shoulder dystocia, congenital malformations, and low 5-min Apgar score.

CONCLUSION

"Isolated" obesity, although not a risk factor for adverse perinatal outcomes, is an independent risk factor for CD.