Contribution of Maternal Overweight and Obesity to the Occurrence of Adverse Pregnancy Outcomes

Abstract

(Aust N Z J Obstet Gynaecol. 2019;59:367–374) In recent decades, an increase in the proportion of parturients in Australia who are overweight or obese has led to an increase in major pregnancy complications directly related to weight. Complications including gestational diabetes mellitus (GDM), hypertensive disorders (including preeclampsia), and operative delivery are all increased with higher body mass index. The babies of overweight and obese women are also affected with increased risks of miscarriage, preterm birth (PTB), macrosomia, shoulder dystocia, congenital anomalies, and neonatal death. This study assessed the population-level contribution of maternal overweight and obesity to adverse pregnancy outcomes and also estimated the extent to which beneficial intervention strategies involving weight loss could decrease the incidence of adverse pregnancy outcomes in the population. This involved the use of population attributable fractions (PAF), which allows hypothetical estimates of the proportion of the outcomes that could be potentially prevented if exposure to a specific risk factor (ie, maternal obesity) was eliminated or minimized.