Adverse perinatal outcomes for obese women are influenced by the presence of comorbid diabetes and hypertensive disorders.

Aubry, Evelyne M; Oelhafen, Stephan; Fankhauser, Niklaus; Raio, Luigi; Cignacco, Eva L (2019). Adverse perinatal outcomes for obese women are influenced by the presence of comorbid diabetes and hypertensive disorders. Scientific Reports, 9(1), p. 9793. Nature Publishing Group 10.1038/s41598-019-46179-8

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Maternal obesity often occurs together with comorbid diabetes and hypertensive disorders. All three conditions are independently associated with negative perinatal outcomes. Our objective was to determine the risk and burden of adverse perinatal outcome that could be attributed to maternal obesity in combination with a comorbid status. We analyzed data from 324'664 singleton deliveries in Switzerland between 2005 and 2016. For the association of maternal obesity in the presence or absence of comorbidities with various perinatal outcomes, we estimated adjusted relative risk (RR) using multivariable regression modeling and determined the multivariable-adjusted attributable fraction of the population (AFp). Obesity was a main predictor for macrosomia, fracture of the clavicle, failure to progress in labor and prolonged labor. By stratifying women based on comorbidities, we identified significantly increased risk for preterm birth and early neonatal death only for women diagnosed with a comorbidity. However, various other outcomes were independently associated with either obesity or comorbidities. The AFp showed greatest reduction in comorbidities (15.4/15.0/13.2%), in macrosomia (6.3%) and in shoulder dystocia (4.8%) if all women were to become non-obese. We suggest that comorbidities such as diabetes and hypertensive disorders should be considered when relating maternal obesity to adverse perinatal outcomes.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
08 Faculty of Science > Department of Biology > Institute of Cell Biology

UniBE Contributor:

Fankhauser, Niklaus and Raio, Luigi

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
500 Science > 570 Life sciences; biology

ISSN:

2045-2322

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

18 Jul 2019 09:16

Last Modified:

22 Oct 2019 20:24

Publisher DOI:

10.1038/s41598-019-46179-8

PubMed ID:

31278325

BORIS DOI:

10.7892/boris.131843

URI:

https://boris.unibe.ch/id/eprint/131843

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