Obesidade durante a gravidez: resultados adversos da gestação e do parto

Abstract

To evaluate the influence of maternal obesity on pregnancy, childbirth, and neonatal outcomes. A cross-sectional study with 298 postpartum women. Information was obtained through interviews and access to patients' medical records. The patients were divided into three groups according to their pre-gestational body mass index: normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30.0 kg/m2). Data are reported as adjusted odds ratios with 95% confidence interval (95%CI) following multinomial logistic regression analysis to account for confounding variables. Compared to pregnant women with normal body mass index, overweight women had greater chances of having cesarean delivery, odds ratio (OR) of 2.2 and 95%CI 1.3-3.9, and obese women even more (OR=4.2; 95%CI 2.1-8.1). The chances of gestational diabetes increased in the Overweight (OR=2.5; 95%CI 1.1-5.6) and Obese groups (OR=11.1; 95%CI 5.0-24.6). The occurrence of hypertensive syndrome was also higher in overweight (OR=3.2; 95%CI 1.2-8.1) and obese pregnant women (OR=7.5; 95%CI 2.9-19.1). Major postpartum hemorrhage only showed greater values in the obese women group (OR=4.1; 95%CI 1.1-15.8). Regarding the newborns, the probability of a low Apgar score at first minute was higher in the Obese Group (OR=5.5; 95%CI 1.2-23.7) and chances of macrosomia were higher in the Overweight Group (OR=2.9; 95%CI 1.3-6.3). Data regarding neonatal hypoglycemia were not conclusive. Excessive weight (overweight and obesity) during pregnancy increases the chance of maternal complications (gestational diabetes, hypertensive syndrome, and major postpartum hemorrhage) and neonatal outcomes (cesarean delivery, macrosomia, and low Apgar score).