Maternal super-obesity and perinatal outcomes in Australia: A national population-based cohort study

Sullivan, Elizabeth A., Dickinson, Jan E., Vaughan, Geraldine A., Peek, Michael J., Ellwood, David, Homer, Caroline SE., Knight, Marian, McLintock, Claire, Wang, Alex, Pollock, Wendy, Jackson Pulver, Lisa, Li, Zhuoyang, Javid, Nasrin, Denney-Wilson, Elizabeth and Callaway, Leonie (2015) Maternal super-obesity and perinatal outcomes in Australia: A national population-based cohort study. BMC Pregnancy and Childbirth, 15 322: . doi:10.1186/s12884-015-0693-y

Author Sullivan, Elizabeth A.
Dickinson, Jan E.
Vaughan, Geraldine A.
Peek, Michael J.
Ellwood, David
Homer, Caroline SE.
Knight, Marian
McLintock, Claire
Wang, Alex
Pollock, Wendy
Jackson Pulver, Lisa
Li, Zhuoyang
Javid, Nasrin
Denney-Wilson, Elizabeth
Callaway, Leonie
Title Maternal super-obesity and perinatal outcomes in Australia: A national population-based cohort study
Journal name BMC Pregnancy and Childbirth   Check publisher's open access policy
ISSN 1471-2393
Publication date 2015-12-02
Year available 2015
Sub-type Article (original research)
DOI 10.1186/s12884-015-0693-y
Open Access Status DOI
Volume 15
Issue 322
Total pages 10
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2016
Language eng
Formatted abstract
Background: Super-obesity is associated with significantly elevated rates of obstetric complications, adverse perinatal outcomes and interventions. The purpose of this study was to determine the prevalence, risk factors, management and perinatal outcomes of super-obese women giving birth in Australia.

Methods: A national population-based cohort study. Super-obese pregnant women (body mass index (BMI) >50 kg/m2 or weight >140 kg) who gave birth between January 1 and October 31, 2010 and a comparison cohort were identified using the Australasian Maternity Outcomes Surveillance System (AMOSS). Outcomes included maternal and perinatal morbidity and mortality. Prevalence estimates calculated with 95 % confidence intervals (CIs). Adjusted odds ratios (ORs) were calculated using multivariable logistic regression.

Results 370 super-obese women with a median BMI of 52.8 kg/m2 (range 40.9–79.9 kg/m2) and prevalence of 2.1 per 1 000 women giving birth (95 % CI: 1.96–2.40). Super-obese women were significantly more likely to be public patients (96.2 %), smoke (23.8 %) and be socio-economically disadvantaged (36.2 %). Compared with other women, super-obese women had a significantly higher risk for obstetric (adjusted odds ratio (AOR) 2.42, 95 % CI: 1.77–3.29) and medical (AOR: 2.89, 95 % CI: 2.64–4.11) complications during pregnancy, birth by caesarean section (51.6 %) and admission to special care (HDU/ICU) (6.2 %). The 372 babies born to 365 super-obese women with outcomes known had significantly higher rates of birthweight ≥4500 g (AOR 19.94, 95 % CI: 6.81–58.36), hospital transfer (AOR 3.81, 95 % CI: 1.93–7.55) and admission to Neonatal Intensive Care Unit (NICU) (AOR 1.83, 95 % CI: 1.27–2.65) compared to babies of the comparison group, but not prematurity (10.5 % versus 9.2 %) or perinatal mortality (11.0 (95 % CI: 4.3–28.0) versus 6.6 (95 % CI: 2.6- 16.8) per 1 000 singleton births).

Conclusions: Super-obesity in pregnancy in Australia is associated with increased rates of pregnancy and birth complications, and with social disadvantage. There is an urgent need to further address risk factors leading to super-obesity among pregnant women and for maternity services to better address pre-pregnancy and pregnancy care to reduce associated inequalities in perinatal outcomes.
Keyword Super-obesity
Perinatal outcomesObesity
Maternal socio-economic disadvantage
Obstetric complications
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: School of Medicine Publications
Official 2016 Collection
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Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 2 times in Scopus Article | Citations
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