Impact of maternal obesity on the fetal electrocardiogram during labor

Abstract

Objective: Maternal obesity affects one in every five women giving birth worldwide. This condition is associated with adverse perinatal outcomes, as well as increased morbidity and mortality for mother and offspring.

Methods: We carried out a prospective study at the University of Pecs Medical Center, Pecs, Hungary, between 1 January 2013 and 1 January 2014. We enrolled 60 obese (body mass index >30 kg/m²) low-risk pregnant women and 108 age-, ethnicity-, and parity-matched nonobese pregnant control subjects. The ST segment of the fetal electrocardiogram was assessed by STAN® monitoring. Neonatal outcomes and cord gas analysis of the umbilical vessels were evaluated after birth.

Results: No infant with definitive metabolic acidosis was delivered in either group. We observed 32 and 106 ST events in the obese and control group, respectively, but this difference was not statistically significant. To date, none of the infants delivered as part of this study have demonstrated developmental insufficiency.

Conclusions: Obesity might not influence the fetal electrocardiogram during labor as an independent risk factor for adverse pregnancy outcomes. Studies with larger cohort sizes are needed to confirm our findings.

Keywords:

• Direct fetal monitoring
• obesity
• STAN®
• ST analysis

Acknowledgements

We thank the medical staff of the University of Pecs Clinical Center, Department of Neonatology, as well as the nurses, midwives, and fellow physicians who collaborated with us on the labor ward. We also thank Drs. Tibor Ertl and Lajos Bogar for their support, helpful comments, and discussion.

Declaration of interest

The authors have no conflicts of interest to report.

This study was funded by the project “Increasing the success rate of in vitro fertilization with non-invasive methods” to J.B. (SROP-4.2.2.D-15/1/KONV-2015–0004).