Perinatal outcomes of obese women: a review of the literature.

OBJECTIVE

To review the literature addressing the effect of obesity on pregnancy outcomes and to identify practice and research implications.

DATA SOURCES

Computerized searches in Medline and CINAHL, as well as references cited in articles reviewed. Key words used in the search were as follows: pregnancy and obesity; pregnancy complications; weight gain and pregnancy; weight gain and complications; fat distribution and pregnancy and complications; and obstetrics and obesity.

STUDY SELECTION

Articles and comprehensive works from indexed journals in the English language relevant to key words and published after 1978 were evaluated.

DATA EXTRACTION

Data were extracted and organized under the following headings: methodologic issues; physiologic adjustments; antepartum, intrapartum, postpartum and newborn outcomes; and cost.

DATA SYNTHESIS

Obese pregnant women experience more gestational diabetes, neural tube defects, preeclampsia, induction, primary cesarean, and postpartum infection than pregnant women who are not obese.

CONCLUSIONS

Pregnant women who are obese are at increased risk for certain complications during pregnancy, birth, and postpartum. Little is known about the effect that fat distribution (upper versus lower, which is influential in nonpregnant populations) has on obstetric complications. Even less is known about obese pregnant women's perceptions of risk, changes in lifestyle, functioning, health behaviors, and symptoms experienced during pregnancy.