Obesity may be as important as hypertension and diabetes as a modifiable risk factor to improve birth outcomes, the study authors wrote in the journal Obstetrics and Gynecology.
“As obstetricians, we have the unique responsibility of thinking about multiple lives, such as the woman carrying the pregnancy and the fetus developing in the womb,” said study leader Dr. Brock Polnaszek of Barnes-Jewish Hospital and Washington University in St. Louis, Missouri, in an email to Reuters Health.
Polnaszek and colleagues studied 3,311 obese women and 3,147 non-obese women who had full-term vaginal deliveries. None of them had diabetes or hypertension.
About nine percent of the babies of obese mothers had complications, compared to about seven percent of infants born to non-obese women.
Specifically, the newborns of obese patients were more likely to have signs and symptoms suggesting a dangerous form of infection called sepsis. But while babies of obese mothers were more likely to appear sick enough for sepsis to be a possibility, bacteria culture tests showed actual sepsis rates didn’t differ between the groups, the authors note.
Also, while the rates of these problems were very low, the infants of obese mothers were more likely to have brain damage caused by insufficient oxygen and to need to have their body temperature drastically reduced to protect the brain.
“Some risks, such as stillbirth, were attributed in the past to diabetes but have been shown to be complications of pre-pregnancy obesity instead,” said Dr. Isaac Blickstein of Kaplan Medical Center and Hadassah-Hebrew University School of Medicine in Jerusalem, Israel. Blickstein, who wasn’t involved with this study, researches risks related to maternal obesity.
“Obesity needs serious attention, maybe even more than gestational diabetes receives,” Blickstein said. “Doctors are happy to test women and implement therapy for gestational diabetes, but they fail, in general, to educate their patients.”
Because obesity is an inflammatory disease, it can alter the fetal environment, the study authors wrote. This could be exacerbated by the additional effects of strained labor. In the current study, obese women were more likely to be induced, have a prior cesarean delivery, have a prolonged first stage of labor, and need oxytocin during labor. Babies of obese mothers also had higher birth weight.
“As the epidemic of obesity continues, this identifies yet another set of serious negative perinatal outcomes,” said Dr. Jeffrey Gould, who directs the Perinatal Epidemiology and Health Outcomes Research Unit at Stanford University Medical Center in Palo Alto, California.
Gould, who wasn’t involved with this study, told Reuters Health by email, “This is a call to action, or rather, a call to two actions. The first is to develop nationally effective strategies to reduce the obesity epidemic. The second is for (obstetricians) to continue to perfect their approaches to the perinatal care of all obese women.”...