Preeclampsia, C-sections, dystocia: soaring obesity = more complications.(News)

HOUSTON -- Excess maternal weight and obesity rose an "alarming" 41% between 1991 and 2001 in the first statewide population study of pregnancy and body mass index, with profound implications in terms of complications and cesarean section rates, reported Dr. D. Yvette LaCoursiere of the University of Utah. Salt Lake City.

Preeclampsia, eclampsia, dystocia, cesarean section, and delivery of a baby weighing more than 4,000 g were all significantly elevated in women who were overweight or obese at conception. (See table on page 2.) These associations remained even after controlling for such factors as age, race, parity, weight gain, and preexisting hypertension or diabetes. Dr. LaCoursiere said at the annual meeting of the Society for Gynecologic Investigation.

No increased odds were found for anesthetic complications, preterm labor, or small-for-gestational-age infants, she said.

Dr. LaCoursiere and her associates at the university analyzed 507,791 pregnancies representing all live deliveries in Utah over a 10-year period. Frank obesity at delivery, defined as a body mass index (BMI) greater than 30, increased 36% during the decade. By 2001, nearly 1 in 20 women met the definition of severe obesity at delivery, a BMI greater than 40, or the equivalent of a 5-foot-4-inch woman weighing 225 pounds--a twofold increase over 1991.

The sudden and prodigious increase in BMIs reverberated across many measures:

* A subanalysis of 149,883 nulliparous women determined that C-sections were nearly twice as common in heavier mothers, even after controlling for potential confounders, said Dr. LaCoursiere of the department of obstetrics and gynecology at the university.

The adjusted odds ratio of a C-section was 1.52 for an overweight woman (BMI 25-29.0); 2.30 for a woman with class I obesity (BMI 30-34.9); 3.34 for a ...