Maternal super-obesity and perinatal outcomes in Australia: A national population-based cohort study

Sullivan, EA; Dickinson, JE; Vaughan, GA; Peek, MJ; Ellwood, D; Homer, CSE; Knight, M; McLintock, C; Wang, A; Pollock, W; Jackson Pulver, L; Li, Z; Javid, N; Denney-Wilson, E; Callaway, L

Maternal super-obesity and perinatal outcomes in Australia: A national population-based cohort study

Sullivan, EA

Dickinson, JE Vaughan, GA

Peek, MJ Ellwood, D Homer, CSE

Knight, M McLintock, C Wang, A

Pollock, W Jackson Pulver, L Li, Z

Javid, N Denney-Wilson, E

Callaway, L

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Publication Type:: Journal Article
Citation:: BMC Pregnancy and Childbirth, 2015, 15 (1)
Issue Date:: 2015-12-02

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Field	Value	Language
dc.contributor.author	Sullivan, EA https://orcid.org/0000-0002-8718-2753	en_US
dc.contributor.author	Dickinson, JE	en_US
dc.contributor.author	Vaughan, GA https://orcid.org/0000-0002-0132-9946	en_US
dc.contributor.author	Peek, MJ	en_US
dc.contributor.author	Ellwood, D	en_US
dc.contributor.author	Homer, CSE https://orcid.org/0000-0002-7454-3011	en_US
dc.contributor.author	Knight, M	en_US
dc.contributor.author	McLintock, C	en_US
dc.contributor.author	Wang, A https://orcid.org/0000-0002-3656-4284	en_US
dc.contributor.author	Pollock, W	en_US
dc.contributor.author	Jackson Pulver, L	en_US
dc.contributor.author	Li, Z https://orcid.org/0000-0002-7622-150X	en_US
dc.contributor.author	Javid, N	en_US
dc.contributor.author	Denney-Wilson, E https://orcid.org/0000-0001-9879-4969	en_US
dc.contributor.author	Callaway, L	en_US
dc.date.available	2015-10-05	en_US
dc.date.issued	2015-12-02	en_US
dc.identifier.citation	BMC Pregnancy and Childbirth, 2015, 15 (1)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/40289
dc.description.abstract	© 2015 Sullivan et al. Background: Super-obesity is associated with significantly elevated rates of obstetric complications, adverse perinatal outcomes and interventions. The purpose of this study was to determine the prevalence, risk factors, management and perinatal outcomes of super-obese women giving birth in Australia. Methods: A national population-based cohort study. Super-obese pregnant women (body mass index (BMI) >50 kg/m2 or weight >140 kg) who gave birth between January 1 and October 31, 2010 and a comparison cohort were identified using the Australasian Maternity Outcomes Surveillance System (AMOSS). Outcomes included maternal and perinatal morbidity and mortality. Prevalence estimates calculated with 95 % confidence intervals (CIs). Adjusted odds ratios (ORs) were calculated using multivariable logistic regression. Results: 370 super-obese women with a median BMI of 52.8 kg/m2 (range 40.9-79.9 kg/m2) and prevalence of 2.1 per 1 000 women giving birth (95 % CI: 1.96-2.40). Super-obese women were significantly more likely to be public patients (96.2 %), smoke (23.8 %) and be socio-economically disadvantaged (36.2 %). Compared with other women, super-obese women had a significantly higher risk for obstetric (adjusted odds ratio (AOR) 2.42, 95 % CI: 1.77-3.29) and medical (AOR: 2.89, 95 % CI: 2.64-4.11) complications during pregnancy, birth by caesarean section (51.6 %) and admission to special care (HDU/ICU) (6.2 %). The 372 babies born to 365 super-obese women with outcomes known had significantly higher rates of birthweight ≥4500 g (AOR 19.94, 95 % CI: 6.81-58.36), hospital transfer (AOR 3.81, 95 % CI: 1.93-7.55) and admission to Neonatal Intensive Care Unit (NICU) (AOR 1.83, 95 % CI: 1.27-2.65) compared to babies of the comparison group, but not prematurity (10.5 % versus 9.2 %) or perinatal mortality (11.0 (95 % CI: 4.3-28.0) versus 6.6 (95 % CI: 2.6- 16.8) per 1 000 singleton births). Conclusions: Super-obesity in pregnancy in Australia is associated with increased rates of pregnancy and birth complications, and with social disadvantage. There is an urgent need to further address risk factors leading to super-obesity among pregnant women and for maternity services to better address pre-pregnancy and pregnancy care to reduce associated inequalities in perinatal outcomes.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/1024206
dc.relation	http://purl.org/au-research/grants/nhmrc/510298
dc.relation.ispartof	BMC Pregnancy and Childbirth	en_US
dc.relation.isbasedon	10.1186/s12884-015-0693-y	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Pregnancy Complications	en_US
dc.subject.mesh	Pre-Eclampsia	en_US
dc.subject.mesh	Obesity, Morbid	en_US
dc.subject.mesh	Body Weight	en_US
dc.subject.mesh	Birth Weight	en_US
dc.subject.mesh	Apgar Score	en_US
dc.subject.mesh	Body Mass Index	en_US
dc.subject.mesh	Pregnancy Outcome	en_US
dc.subject.mesh	Cesarean Section	en_US
dc.subject.mesh	Odds Ratio	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Infant, Newborn	en_US
dc.subject.mesh	Maternal Health Services	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Perinatal Mortality	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	Maternal super-obesity and perinatal outcomes in Australia: A national population-based cohort study	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	15	en_US
utslib.for	1110 Nursing	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	open_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	15	en_US

Abstract:

© 2015 Sullivan et al. Background: Super-obesity is associated with significantly elevated rates of obstetric complications, adverse perinatal outcomes and interventions. The purpose of this study was to determine the prevalence, risk factors, management and perinatal outcomes of super-obese women giving birth in Australia. Methods: A national population-based cohort study. Super-obese pregnant women (body mass index (BMI) >50 kg/m2 or weight >140 kg) who gave birth between January 1 and October 31, 2010 and a comparison cohort were identified using the Australasian Maternity Outcomes Surveillance System (AMOSS). Outcomes included maternal and perinatal morbidity and mortality. Prevalence estimates calculated with 95 % confidence intervals (CIs). Adjusted odds ratios (ORs) were calculated using multivariable logistic regression. Results: 370 super-obese women with a median BMI of 52.8 kg/m2 (range 40.9-79.9 kg/m2) and prevalence of 2.1 per 1 000 women giving birth (95 % CI: 1.96-2.40). Super-obese women were significantly more likely to be public patients (96.2 %), smoke (23.8 %) and be socio-economically disadvantaged (36.2 %). Compared with other women, super-obese women had a significantly higher risk for obstetric (adjusted odds ratio (AOR) 2.42, 95 % CI: 1.77-3.29) and medical (AOR: 2.89, 95 % CI: 2.64-4.11) complications during pregnancy, birth by caesarean section (51.6 %) and admission to special care (HDU/ICU) (6.2 %). The 372 babies born to 365 super-obese women with outcomes known had significantly higher rates of birthweight ≥4500 g (AOR 19.94, 95 % CI: 6.81-58.36), hospital transfer (AOR 3.81, 95 % CI: 1.93-7.55) and admission to Neonatal Intensive Care Unit (NICU) (AOR 1.83, 95 % CI: 1.27-2.65) compared to babies of the comparison group, but not prematurity (10.5 % versus 9.2 %) or perinatal mortality (11.0 (95 % CI: 4.3-28.0) versus 6.6 (95 % CI: 2.6- 16.8) per 1 000 singleton births). Conclusions: Super-obesity in pregnancy in Australia is associated with increased rates of pregnancy and birth complications, and with social disadvantage. There is an urgent need to further address risk factors leading to super-obesity among pregnant women and for maternity services to better address pre-pregnancy and pregnancy care to reduce associated inequalities in perinatal outcomes.

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http://hdl.handle.net/10453/40289