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Obese Women Face High First-Time Pregnancy Risks

Cesarean rate in UK study was higher than in any other group ever studied, researchers report

MONDAY, March 30 (HealthDay News) -- Obese women who are pregnant for the first time have an elevated risk of preterm birth, cesarean section delivery and preeclampsia, according to a report in the April issue of the American Journal of Obstetrics & Gynecology.

Daghni Rajasingam, of Kings College London in the United Kingdom, and colleagues assessed 385 obese women who were pregnant for the first time, drawn from the placebo arm of a 2006 trial. The women's blood was comprehensively tested for lipids (high- and low-density lipoprotein, triglycerides), ascorbic acid (vitamin C), uric acid, retinol and other biomarkers.

According to the researchers, the cesarean section delivery rate was 39 percent in the cohort, the highest ever found in any study of obese pregnancy worldwide. The preterm birth rate was 11.9 percent, which is twice the rate for all births in the general population in the United Kingdom, they note. Also, increased body mass index (BMI) was associated with increased preeclampsia rates; for a BMI of 30-34 kg/m2, preeclampsia incidence was 8.3 percent, which increased to 19 percent for a BMI of 40 kg/m2. And, the authors note, 18.8 percent of infants were small for gestational age.

"This prospective study of a contemporary cohort highlights the need to address parity when assessing risk among obese pregnant women. The high incidences of small-for-gestational-age and preterm birth have clinically important implications for serial fetal surveillance, and both will contribute to the increased use of health care resources," Rajasingam and colleagues write.

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