2021, Number 07
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Ginecol Obstet Mex 2021; 89 (07)
Obesity and its maternal perinatal complications
Panduro-Barón JG, Barrios-Prieto E, Pérez-Molina JJ, Panduro-Moore EG, Rosas-Gómez ESM, Quezada-Figueroa NA
Language: Spanish
References: 30
Page: 530-539
PDF size: 196.97 Kb.
ABSTRACT
Objective: To describe the most frequent maternal and perinatal complications in
pregnant women with obesity.
Materials and Methods: Cross-sectional, comparative study conducted at the
Hospital Civil de Guadalajara Dr. Juan I. Menchaca between 2017 and 2019. A group
of pregnant patients with body mass index (BMI) greater than 30 kg/m
2, with singleton
fetus, with more than 29 weeks of pregnancy versus a control group of equal number
of pregnant women with singleton fetus and more than 29 weeks of gestation and
normal BMI (20.1 to 24.9 kg/m
2) were compared. Fisher's 2, Fisher's exact and odds
ratio tests were applied to the results.
Results: 380 pregnant women with obesity were compared with an equal number of
patients with normal BMI. The women were older (mean 27.9
vs 21.9), worked more
outside their home (146
vs 62), more multi-pregnancy 92
vs 55) and that in pregnancy
they had more problems of threatened abortion (91
vs 47), diabetes (70
vs 21), hypertension
(68
vs 17) and abruptio placentae (8
vs 2), with a more frequent cesarean section
(243
vs 162), results that had a statistically significant difference. Neonates had lower
Apgar (Apgar ≤ 7 at minute 61
vs 30) and more macrosomia (47
vs 18) results that
had a statistically significant difference, not being the same with malformations (14
vs
7), and a higher number of admissions to the neonatal intensive care unit (44
vs 29),
although they were more frequent, they had no statistical difference.
Conclusions: Pregnancy in women with obesity is more frequently associated
with both maternal and perinatal problems, so pregnancy should be planned in this
group of women.
REFERENCES
ACOG. Obesity in pregnancy. Practice Bulletin. No. 156. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015; 126 (6): e112-26. doi: 10.1097/ AOG.0000000000001211
Rivera DJA, Colchero MA, Fuentes ML, González de Cosío MT, et al. La obesidad en México. Estado de la política pública y recomendaciones para su prevención y control. Cuernavaca: Instituto Nacional de Salud Pública, 2018.
ACOG. Obesity in adolescents. Committee Opinion No. 714. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017; 130 (3): e127-40. doi: 10.1097/ AOG.0000000000002297
Cervantes RDL, Haro AME, Ayala FRI, Haro EI, et al. Prevalencia de obesidad y ganancia de peso en mujeres embarazadas. Aten Fam 2019; 26 (2): 43-47. http://dx.doi. org/10.22201/facmed.14058871p.2019.2.68824
Pacheco RJ. Gestación en la mujer obesa: consideraciones especiales. An Fac Med 2017; 78 (2): 207-214. doi: http:// dx.doi.org/10.15381/anales.v78i2.13219
Lozano BA, Betancourth MWR, Turcios ULJ, Cueva NJE, et al. Sobrepeso y obesidad en el embarazo: complicaciones y manejo. Archivos de Medicina 2016; 12 (3): 11-17. http:// doi. 103823/1310
Farías M. Obesidad materna: severo problema de salud pública en Chile. Rev Chil Obstet Ginecol 2013; 76 (6): 409- 12. http://dx.doi.org/10.4067/S0717-75262013000600001
ACOG. Ethical considerations for the care of patients with obesity. Committee Opinion No. 763. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019; 133 (1): e90-6. doi: 10.1097/AOG.0000000000003016
Velasco LMR. La desnutrición y la obesidad: dos problemas de salud que coexisten en México. Rev Mex Pediatr 2016; 83 (1): 5-6.
Bicocca, MJ, Mendez FH, Chauhan SP, Sibai BM. Maternal obesity and the risk of early-onset and late-onset hypertensive disorders of pregnancy. Obstet Gynecol 2020; 136 (1): 118-127. doi: 10.1097/AOG.0000000000003901
Fernández AJJ, Mesa PC, Vilar SA, Soto PE, et al. Sobrepeso y obesidad como factores de riesgo de los estados hipertensivos del embarazo: estudio de cohortes retrospectivo. Nutr Hosp 2018; 35 (4): 874-880. doi: http://dx.doi. org/10.20960/nh.1702
Sánchez CV, Avila VMA, Peraza GF, Vadillo OF, et al. Complicaciones perinatales asociadas con la ganancia excesiva de peso durante el embarazo. Ginecol Obstet Mex 2017; 85 (2): 64-70.
Sohlberg S, Stephansson O, Cnattingius S, Wikström AK. Maternal body mass index, height, and risks of preeclampsia. Am J Hypertens 2012; 25 (1): 120-5. doi: https://doi. org/10.1038/ajh.2011.175
ACOG. Macrosomia. Practice Bulletin No. 216. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020; 125 (1): e18-35.
Claros BDI, Mendoza TLA. Impacto de los trastornos hipertensivos, la diabetes y la obesidad materna sobre el peso, la edad gestacional al nacer y la mortalidad neonatal. Rev Chil Obstet Ginecol 2016; 81 (6): 480-8. http://dx.doi. org/10.4067/S0717-75262016000600005
Arrowsmith S, Wray S, Quenby S. Maternal obesity and labour complications following induction of labour in prolonged pregnancy. BJOG 2011 (1); 118: 578-88. https:// doi.org/10.1111/j.1471-0528.2010.02889.x
Yao R, Goetzinger KR, Crimmins SD, Kopelman JN, et al. Association of maternal obesity with maternal and neonatal outcomes in cases of uterine rupture. Obstet Gynecol 2017; 129 (4): 683-8. doi: 10.1097/AOG.0000000000001930
Yu YH, Bodnar LM, Himes KP, Brooks MM, et al. Association of overweight and obesity development between pregnancies with stillbirth and infant mortality in a cohort of multiparous women. Obstet Gynecol 2020; 135 (3): 634-43. doi: 10.1097/AOG.0000000000003677
Pickens CM, Hogue CJ, Howards PP, Kramer MR, et al. The association between gestational weight gain z-score and stillbirth: a case-control study. BMC Pregnancy Childbirth 2019; 19: 451-64. doi: https://doi.org/10.1186/s12884- 019-2595-x
Aune D, Saugstad OD, Henriksen T, Tonstad S. Maternal body mass index and the risk of fetal death, stillbirth, and infant death. JAMA 2014; 311(15: 1536-46. doi: https:// doi:10.1001]/jama.2014.2269
Racusin D, Stevens B, Campbell G, Aagaard TK. Obesity and the risk and detection of fetal malformations. Semin Perinatol 2012; 36 (3): 213-21. doi: https://doi:10.1053/j. semperi.2012.05.001
Stothard KJ, Tennant PWG, Bell R, Rankin J. Materna overweight and obesity and the risk of congenital anomalies. JAMA 2009; 301 (6): 636-50. doi: 10.1001/ jama.2009.113
Stamilio DM, Scifres CM. Extreme obesity and postcesarean maternal complications. Obstet Gynecol 2014; 124(2): 227- 32. doi: 10.1097/AOG.0000000000000384
Aguilar CMJ, Baena GL, Sánchez LAM. Obesidad durante el embarazo y su influencia en el sobrepeso en la edad infantil. Nutr Hosp 2016; 33 (Supl. 5): 18-23. doi: http;// dx.doi.org/10.20960/nh.516
Howell KR, Powell TL. Effects of maternal obesity on placental function and fetal development. Reproduction 2017; 153(3): 97-108. doi: http://doi:10.1530/REP-16- 0495
Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ 2017; 360:j1. doi: http://doi: 10.1136/bmj.j1
ACOG. Weight gain during pregnancy. Committee Opinion No. 548. Obstet Gynecol 2013: 121(1): 210-2.
ACOG. Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 650. Obstet Gynecol 2015; 126 (6): 1326-7.
Martínez VIG. Obesidad y embarazo: oportunidad única para el ginecoobstetra. Ginecol Obstet Mex 2017; 85 (4).
ACOG. Challenges for overweight and obese women. Committee Opinion No. 591. Obstet Gynecol 2014; 123(3): 726-30. doi: 10.1097/01.AOG.0000444457.29401.a0.