Maternal Obesity Raises Pregnancy Risks

NEW YORK (Reuters Health) - Obese women experience more pregnancy and childbirth complications than normal-weight women do, and the rising tide of obesity in the US could stall progress in improving outcomes for mothers and newborns, Alabama researchers report.

The investigators used a computerized database to track obesity and pregnancy outcomes among more than 53,000 women who received prenatal care at Alabama clinics between 1980 and 1999. The researchers found that maternal obesity grew steadily over the two decades, and along with the rise came more gestational diabetes and larger-than-normal newborns.

Gestational diabetes refers to an impairment in the body's use of blood sugar during pregnancy that can potentially progress to diabetes after childbirth, although it usually goes away. Gestational diabetes can also cause the fetus to become significantly larger than normal, which puts women and their newborns at higher risk of birth trauma.

Obese women in the study were also more likely than non-obese women to have Cesarean deliveries, although the overall rate of C-sections did not increase over the study period.

Dr. George C. Lu and his colleagues at the University of Alabama at Birmingham reported their findings in a recent issue of the American Journal of Obstetrics and Gynecology.

From 1980 to 1999, the average weight of women during their first prenatal visit increased from 144 pounds to 172 pounds, the report indicates. The percentage considered obese rose from about 7% to 24%.

At the same time, the rate of gestational diabetes increased by nearly one-quarter, with a similar rise in larger-than-normal newborns. Throughout the study, obese women were 50% to 80% more likely than other women to need a C-section.

These ``dramatic trends'' in maternal obesity ``mirror those from other reports on the general US population,'' Lu's team writes. They acknowledge, however, that because Alabama has one of the nation's highest obesity rates and most of the women in the study were African American--a population at higher obesity risk--these findings may not be true of all US women.

Still, they point out, the growth of obesity is a ''universal phenomenon'' in the United States.

``Our data demonstrate that maternal obesity is a direct countervailing force to the general improvements in pregnancy outcome achieved over the (study) period,'' Lu and colleagues conclude, ``and these data must be addressed if future pregnancy outcomes are to be optimal.''

SOURCE: American Journal of Obstetrics and Gynecology 2001;185:845-849.

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