Abstract
Objectives
Maternal obesity during pregnancy is associated with adverse intrauterine events and fetal outcomes and may increase the risk of obesity and metabolic disease development in offspring. Higher parity, regardless of socioeconomic status, is associated with increased maternal body mass index (BMI). In this study, we examined the relationship between parity, maternal obesity, and fetal outcomes in a large sample of mother-neonate pairs from Lower Saxony, Germany.
Methods
This retrospective cohort study examined pseudonymized data of a non-selected singleton cohort from Lower Saxony’s statewide quality assurance initiative. 448,963 cases were included. Newborn outcomes were assessed in relation to maternal BMI and parity.
Results
Maternal obesity was associated with an increased risk of placental insufficiency, chorioamnionitis, and fetal distress while giving birth. This effect was present across all parity groups. Fetal presentation did not differ between BMI groups, except for the increased risk of high longitudinal position and shoulder dystocia in obese women. Maternal obesity was also associated with an increased risk of premature birth, low arterial cord blood pH and low 5-min APGAR scores.
Conclusions
Maternal obesity increases the risk of adverse neonatal outcomes. There is a positive correlation between parity and increased maternal BMI. Weight-dependent fetal risk factors increase with parity, while parity-dependent outcomes occur less frequently in multipara. Prevention and intervention programs for women planning to become pregnant can be promising measures to reduce pregnancy and birth complications.
Acknowledgments
The authors greatly appreciate the support of the obstetric hospitals in Lower Saxony and the Ärztekammer Niedersachsen in recruiting participants and providing data.
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Research funding: None declared.
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Author contributions: Conceived and concepted the study: LB CVK MV FK. Study design: LB NR MV. Supervision: LB FK CVK FK SB MV. Analyzed the data: MV NR. Contributed patient information/analysis tools: SB MV NR. Contributed to the writing of the manuscript: LB NR EIY. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: This is a retrospective analysis of birth data from the Lower Saxony Perinatal Survey under the Ethical Approval of the Ethics Committee of the Lower Saxony Medical Association.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2020-0614).
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