Pregnant obese, overweight women have higher risk of perinatal death
Pregnancies among overweight or obese women have a higher risk of perinatal death, with risk partly mediated by a lower gestational age at delivery, according to a study published online March 23 in PLOS ONE.
Jeffrey N. Bone, from the University of British Columbia in Vancouver, Canada, and colleagues quantified the proportion of perinatal deaths among obese and overweight women. Analysis included all singleton births at ≥20 weeks of gestation in British Columbia (2004 to 2017) to 392,820 women.
The researchers found that women with higher body mass index (BMI) had a lower gestational age at delivery. Additionally, perinatal mortality was 0.5 percent and was higher in overweight (adjusted odds ratio [aOR], 1.22) and obese women (aOR, 1.55). Nearly two-thirds of this association (63.1 percent) was mediated by gestational age at delivery (natural indirect effect aOR, 1.32; natural direct effect aOR, 1.18). Effects were similar, but smaller, when comparing overweight women to women with a normal BMI.
"Timely obstetric intervention coupled with access to neonatal intensive care earlier in gestation may further mitigate the risk of neonatal death among infants in these women," the authors write. "To better inform the pregnancy management in obese women, further studies should continue to disentangle the causal pathways under which obesity increases the risk of perinatal death, including, for example, gestational diabetes and other obesity-related pregnancy complications."
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