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Cited by 47Gestational Diabetes Research and ManagementPregnancy and preeclampsia studiesMaternal and Perinatal Health Interventions

Cohort study of high maternal body mass index and the risk of adverse pregnancy and delivery outcomes in Scotland

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Doi, Lawrence, Williams, Andrew James, Marryat, Louise, Frank, John·2020·BMJ Open
DOI 10.1136/bmjopen-2018-026168PMC PMC7045241
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Abstract

Objective: To examine the association between high maternal weight status and complications during pregnancy and delivery. Setting: Scotland. Participants: Data from 132 899 first-time singleton deliveries in Scotland between 2008 and 2015 were used. Women with overweight and obesity were compared with women with normal weight. Associations between maternal body mass index and complications during pregnancy and delivery were evaluated. Outcome measures: Gestational diabetes, gestational hypertension, pre-eclampsia, placenta praevia, placental abruption, induction of labour, elective and emergency caesarean sections, pre-term delivery, post-term delivery, low Apgar score, small for gestational age and large for gestational age. Results: In the multivariable models controlling for potential confounders, we found that, compared with women with normal weight, the odds of the following outcomes were significantly increased for women with overweight and obesity (overweight adjusted ORs; 95% CI, followed by the same for women with obesity): gestational hypertension (1.61; 1.49 to 1.74), (2.48; 2.30 to 2.68); gestational diabetes (2.14; 1.86 to 2.46), (8.25; 7.33 to 9.30); pre-eclampsia (1.46; 1.32 to 1.63) (2.07; 1.87 to 2.29); labour induction (1.28; 1.23 to 1.33), (1.69; 1.62 to 1.76) and emergency caesarean section (1.82; 1.74 to 1.91), (3.14; 3.00 to 3.29). Conclusions: Women with overweight and obesity in Scotland are at greater odds of adverse pregnancy and delivery outcomes. The odds of these conditions increases with increasing body mass index. Health professionals should be empowered and trained to deliver promising dietary and lifestyle interventions to women at risk of overweight and obesity prior to conception, and control excessive weight gain in pregnancy.

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  • Induction is less likely to succeed and obese women are more than three-fold more likely than normal weight women to require an emergency caesarean after induction.

    “However, induction is less likely to succeed and obese women are more than three‐fold more likely than normal weight women to require an emergency caesarean after induction. 83 , 84 , 85”

    From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [83]

    The Results report that women with obesity had higher odds of emergency caesarean than women with normal weight (OR 3.14), but this estimate covers deliveries generally, not emergency caesareans after induction. The Discussion reports a review finding that induction more often ends in caesarean for women with obesity, supporting the direction of the claim but not its three-fold magnitude or emergency-caesarean qualifier. Page numbers were not available in our copy. (LLM, conf=0.88)

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  • Overweight or obese women are more likely to require labour induction.

    “As a result, these women are more likely to require labour induction. 83”

    From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [83]

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Research works printed but not linked: 24

  1. [1]Rooney BL, Schauberger CW Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol 2002; 100: 245– 52. 10.1016/s0029-7844(02)02125-7 12151145 · DOI
  2. [2]Kumari P, Malviya S, Gupta M, et al Association between high maternal body mass index and feto-maternal outcome. J Obes Metab Res 2014; 1: 143– 8. 10.4103/2347-9906.141140 · DOI
  3. [3]Poobalan AS, Aucott LS, Gurung T, et al Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women – systematic review and meta-analysis of cohort studies. Obes Rev 2009; 10: 28– 35. 10.1111/j.1467-789X.2008.00537.x 19021871 · DOI
  4. [4]Rahman MM, Abe SK, Kanda M, et al Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis. Obes Rev 2015; 16: 758– 70. 10.1111/obr.12293 26094567 · DOI
  5. [5]Godfrey KM, Reynolds RM, Prescott SL, et al Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol 2017; 5: 53– 64. 10.1016/S2213-8587(16)30107-3 27743978 PMC5245733 · DOI · Paper page
  6. [6]Morgan KL, Rahman MA, Hill RA, et al Obesity in pregnancy: infant health service utilisation and costs on the NHS. BMJ Open 2015; 5: e008357 10.1136/bmjopen-2015-008357 PMC4663437 26610756 · DOI
  7. [7]Doi L, Williams AJ, Frank J How has child growth around adiposity rebound altered in Scotland since 1990 and what are the risk factors for weight gain using the growing up in Scotland birth cohort 1? BMC Public Health 2016; 16: 1081 10.1186/s12889-016-3752-z 27737667 PMC5064913 · DOI
  8. [8]Denison FC, Norwood P, Bhattacharya S, et al Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study. BJOG 2014; 121: 72– 82. 10.1111/1471-0528.12443 24102880 · DOI
  9. [9]Smith GCS, Shah I, Pell JP, et al Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: a retrospective cohort study. Am J Public Health 2007; 97: 157– 62. 10.2105/AJPH.2005.074294 17138924 PMC1716235 · DOI
  10. [10]Cedergren MI Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004; 103: 219– 24. 10.1097/01.AOG.0000107291.46159.00 14754687 · DOI
  11. [14]Cole TJ, Freeman JV, Preece MA Body mass index reference curves for the UK, 1990. Arch Dis Child 1995; 73: 25– 9. 10.1136/adc.73.1.25 7639544 PMC1511150 · DOI
  12. [15]Freeman JV, Cole TJ, Chinn S, et al Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 1995; 73: 17– 24. 10.1136/adc.73.1.17 7639543 PMC1511167 · DOI
  13. [17]Scott-Pillai R, Spence D, Cardwell CR, et al The impact of body mass index on maternal and neonatal outcomes: a retrospective study in a UK obstetric population, 2004–2011. BJOG 2013; 120: 932– 9. 10.1111/1471-0528.12193 23530609 · DOI
  14. [18]O'Brien TE, Ray JG, Chan WS Maternal body mass index and the risk of preeclampsia: a systematic overview. epidemiology 2003; 14: 368-374. 12859040
  15. [19]Shieh C, Cullen DL, Pike C, et al Intervention strategies for preventing excessive gestational weight gain: systematic review and meta-analysis. Obes Rev 2018; 19: 1093– 109. 10.1111/obr.12691 29806187 · DOI
  16. [20]Thangaratinam S, Rogozinska E, Jolly K, et al Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ 2012; 344: e2088 10.1136/bmj.e2088 22596383 PMC3355191 · DOI · Paper page
  17. [21]Althabe F, Sosa C, Belizán JM, et al Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. Birth 2006; 33: 270– 7. 10.1111/j.1523-536X.2006.00118.x 17150064 · DOI
  18. [22]Ellis JA, Brown CM, Barger B, et al Influence of maternal obesity on labor induction: a systematic review and meta-analysis. J Midwifery Womens Health 2019; 64: 55– 67. 10.1111/jmwh.12935 30648804 PMC6758543 · DOI
  19. [23]Rezaie M, Shahoe R, Shahghebi S The effect of maternal body mass index on the delivery route in nulliparous women. J Public Health Epidemiol 2013; 5: 346– 50.
  20. [25]Abhyankar P, Cheyne H, Maxwell M, et al A realist evaluation of a normal birth programme. Evidence Based Midwifery, 2013 Available: https://www.rcm.org.uk/learning-and-career/learning-and-research/ebm-articles/a-realist-evaluation-of-a-normal-birth 23968777
  21. [26]Cheyne H, Abhyankar P, McCourt C Empowering change: realist evaluation of a Scottish government programme to support normal birth. Midwifery 2013; 29: 1110– 21. 10.1016/j.midw.2013.07.018 23968777 · DOI
  22. [27]Surkan PJ, Hsieh C-C, Johansson ALV, et al Reasons for increasing trends in large for gestational age births. Obstet Gynecol 2004; 104: 720– 6. 10.1097/01.AOG.0000141442.59573.cd 15458892 · DOI
  23. [28]McDonald SD, Han Z, Mulla S, et al Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ 2010; 341: c3428 10.1136/bmj.c3428 20647282 PMC2907482 · DOI
  24. [29]Hendler I, Goldenberg RL, Mercer BM, et al The preterm prediction study: association between maternal body mass index and spontaneous and indicated preterm birth. Am J Obstet Gynecol 2005; 192: 882– 6. 10.1016/j.ajog.2004.09.021 15746686 · DOI · Paper page

Cited by

Sorted by citations

Authors
Doi, L., Williams, A. J., Marryat, L., & Frank, J.
Affiliations
  • Scottish Collaboration for Public Health Research and Policy (GB)
  • University of Exeter (GB)
  • Royal Edinburgh Hospital (GB)
  • Farr Institute (GB)
Corresponding author
Doi, Lawrence
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2020-02
Volume
10
Issue
2
Pages
e026168
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2018-026168
PMC
PMC7045241
OpenAlex
W3008262513
Cited by
47
References
0
Citations by year
2025: 5 · 2024: 24 · 2023: 3 · 2022: 9 · 2021: 4 · 2020: 2
FWCI
2.75
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (submittedVersion, cc-by)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • HighWire Press Open Archive (submittedVersion)
  • St Andrews Research Repository (St Andrews Research Repository) (submittedVersion, cc-by)
Funders
Medical Research Council (MR/K023209/1)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
maternal obesity, maternal overweight, body mass index, adverse pregnancy outcomes, gestational diabetes mellitus, gestational hypertension, preeclampsia, labor induction, cesarean section, preterm birth, gestational weight gain, primiparous women, Scotland
MeSH terms
Adult, Birth Weight, Female, Humans, Infant, Newborn, Obesity, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Risk Factors, Scotland, Cohort Studies, Body Mass Index, Delivery, Obstetric, Overweight

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