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Neonatal morbidity in the offspring of obese women without hypertension or diabetes

Obstetrics and Gynecology Sep 28, 2018

Polnaszek BE, et al. - Researchers assessed independent risk of neonatal morbidity between the offspring of obese vs nonobese women without hypertension or diabetes. Outcomes revealed an increased risk of neonatal morbidity among the offspring of obese women vs nonobese women, even in the absence of maternal hypertension or diabetes.

Methods

  • From 2010 to 2014, researchers performed a secondary analysis of a prospective single-center cohort study of singleton deliveries at or beyond 37 weeks of gestation.
  • They excluded women with diabetes (pregestational or gestational) and hypertensive disorders.
  • For this study, following were assessed as the primary outcomes:
    • 1) a composite neonatal morbidity including death, mechanical ventilation, respiratory distress, meconium aspiration, suspected sepsis, confirmed sepsis, hypoxic–ischemic encephalopathy, therapeutic hypothermia, or seizures; and
    • 2) a composite of neonatal neurologic morbidity including hypoxic–ischemic encephalopathy, therapeutic hypothermia, or seizures.
  • The offspring of obese (body mass index 30 or greater) and nonobese women were compared regarding the primary outcomes.
  • Multivariable logistic regression was used to estimate adjusted odds ratios (ORs).

Results

  • Researchers analyzed 6,458 women who were without diabetes or hypertensive disorders; among these, 3,311 (51%) were obese.
  • Significantly increased risk of the composite neonatal morbidity (9.2% vs 7.2%, adjusted OR 1.39, 95% CI 1.15–1.67) and neurologic neonatal morbidity (0.7% vs 0.3%, adjusted OR 2.84, 95% CI 1.22–6.65) was evident among neonates of obese patients, after adjusting for race.
  • A greater tendency to have hypoxic–ischemic encephalopathy (0.5% vs 0.2%, adjusted OR 2.80, 95% CI 1.02–7.68), hypothermia treatment (0.6% vs 0.2%, adjusted OR 2.92 95% CI 1.17–7.30), and suspected sepsis (7.6% vs 5.8%, adjusted OR 1.45, 95% CI 1.18–1.79) was specifically seen among neonates of obese patients.
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