부산대학교 도서관

OBJECTIVE: To assess the prevalence of overweight and obesity, and the impact of body mass index (BMI) on maternal and neonatal outcomes, in a UK obstetric population. DESIGN: Retrospective study. SETTING: A tertiary referral unit in Northern Ireland. POPULATION: A total of 30 298 singleton pregnancies over an 8-year period, 2004–2011. METHODS: Women were categorised according to World Health Organization classification: underweight (BMI < 18.50 kg/m); normal weight (BMI 18.50–24.99 kg/m; reference group); overweight (BMI 25.00–29.99 kg/m); obese class I (BMI 30.00–34.99 kg/m); obese class II (BMI 35–39.99 kg/m); and obese class III (BMI ≥ 40 kg/m). Maternal and neonatal outcomes were examined using logistic regression, adjusted for confounding variables. MAIN OUTCOME MEASURES: Maternal and neonatal outcomes. RESULTS: Compared with women of normal weight, women who were overweight or obese class I were at significantly increased risk of hypertensive disorders of pregnancy (OR 1.9, 99% CI 1.7–2.3; OR 3.5, 99% CI 2.9–4.2); gestational diabetes mellitus (OR 1.7, 99% CI 1.3–2.3; OR 3.7, 99% CI 2.8–5.0); induction of labour (OR 1.2, 99% CI 1.1–1.3; OR 1.3, 99% CI 1.2–1.5); caesarean section (OR 1.4, 99% CI 1.3–1.5; OR 1.8, 99% CI 1.6–2.0); postpartum haemorrhage (OR 1.4, 99% CI 1.3–1.5; OR 1.8, 1.6–2.0); and macrosomia (OR 1.5, 99% CI 1.3–1.6; OR 1.9, 99% CI 1.6–2.2), with the risks increasing for obese classes II and III. Women in obese class III were at increased risk of preterm delivery (OR 1.6, 99% CI 1.1–2.5), stillbirth (OR 3.0, 99% CI 1.0–9.3), postnatal stay > 5 days (OR 2.1, 99% CI 1.5–3.1), and infant requiring admission to a neonatal unit (OR 1.6, 99% CI 1.0–2.6). CONCLUSIONS: By categorising women into overweight and obesity subclassifications (classes I –III), this study clearly demonstrates an increasing risk of adverse outcomes across BMI categories, with women who are overweight also at significant risk.