Key result
Preconception BMI >50 kg/m2 was associated with higher rates of emergency cesarean section (21% vs 12%) and neonatal intensive care (34% vs 6%) compared to BMI ≤50 kg/m2.
Why the study?
Does preconception BMI >50 kg/m² increase the risk of adverse pregnancy outcomes in women with singleton pregnancies?
Cohort
Does preconception BMI >50 kg/m² increase the risk of adverse pregnancy outcomes in women with singleton pregnancies?
Absolute Event Rate: 21% vs 12%
Extremely high preconception BMI (>50 kg/m²) is associated with significantly increased risks of maternal and neonatal pregnancy complications.
Supports closer surveillance in extreme preconception obesity; leaves open whether interventions reduce cesarean and NICU risks.
We describe characteristics and risk factors regarding pregnancy outcome in women with a preconception body mass index (BMI) >50 kg/m² compared with women with BMI ≤50 kg/m² in a retrospective population cohort study in singleton pregnancies from the Danish Medical Birth Registry. Results were analyzed as relative risks by a two-proportion z-test. Women with preconception BMI >50 kg/m² smoked, developed gestational diabetes and pre-eclampsia, and needed induction of labor more frequently than mothers with BMI ≤50 kg/m². Examination of the case records showed that many attempted vaginal delivery without epidural analgesia, 21% needed an emergency cesarean section (compared with 12% among women with BMI ≤50 kg/m²), and 25% underwent general anesthesia in this context. Many neonates were macrosomic and 34% needed neonatal intensive care and early feeding compared with 6% of neonates from women with BMI ≤50 kg/m². Women with an extremely high preconception BMI develop more pregnancy complications and their neonates appear affected by this as well.
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Bonnesen et al. (2013) conducted a cohort in Pregnancy. Preconception BMI >50 kg/m2 vs. Preconception BMI ≤50 kg/m2 was evaluated on Emergency cesarean section. Preconception BMI >50 kg/m2 was associated with higher rates of emergency cesarean section (21% vs 12%) and neonatal intensive care (34% vs 6%) compared to BMI ≤50 kg/m2.
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