The clinical outcomes of unplanned pregnancy in severely obese women

* This work has been submitted and will be presented in a poster form at the SMFM Pregnancy Meeting on February 2015 (“Severe obesity and the clinical outcomes of unplanned pregnancy” control ID 2066829, final program ID 610).

Abstract

Objective: The objective of this study was to compare the clinical outcomes of unplanned pregnancies among severely obese women with those of planned pregnancies.

Methods: This prospective cohort study included severely obese women (Body Mass Index [BMI] ≥40.0 kg/m²) who delivered a baby weighing ≥500 g over 5 years 2009–2013 in a large university hospital. Maternal weight and height were measured and BMI was calculated at the first prenatal visit.

Results: Of the 650 women, the mean BMI was 43.8 kg/m², mean age was 31.6 years, and 30.0% (n = 195) were nulliparous. Prenatal complications including gestational diabetes mellitus (GDM), hypertensive and thromboembolic disorders occurred in 56.6% (n = 368). Compared with planned pregnancies (58.2%, n = 378), those that were unplanned (41.8%, n = 272) were associated with increased prepregnancy risk factors including essential hypertension (4.0% versus 1.6%, p = 0.03) and depression (6.6% versus 3.2%, p = 0.03). Unplanned pregnancy was associated with a higher macrosomia rate (birthweight > 4.5 kg) compared with planned pregnancies (p = 0.03). This was not explained by a higher GDM rate in unplanned pregnancies. Compared with planned pregnancies, unplanned pregnancies were not associated with increased adverse fetomaternal outcomes.

Conclusion: Despite increased prepregnancy risk factors, in severely obese women, unplanned pregnancies were not associated with increased prenatal complications or adverse pregnancy outcomes compared with planned pregnancies.

Keywords:

• High-risk pregnancy
• severe maternal obesity
• unplanned pregnancy

Acknowledgements

This research was funded by the Crisis Pregnancy Programme of the Health Service Executive in Ireland. The study sponsors had no role in the preparation, approval, or submission of this manuscript.

Declaration of interest

All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

The authors report that they have no conflicts of interest. This study was supported by the Crisis Pregnancy Programme of the Health Services Executive of Ireland.

Notes

* This work has been submitted and will be presented in a poster form at the SMFM Pregnancy Meeting on February 2015 (“Severe obesity and the clinical outcomes of unplanned pregnancy” control ID 2066829, final program ID 610).