Maternal and Neonatal Outcomes among Obese Pregnant Women in King Abdulaziz University Hospital: A Retrospective Single-Center Medical Record Review.

Pregnancy results in different physiological changes to the pregnant body resulting in weight gain. This added weight can result in poor pregnancy outcomes in obese women. To assess the adverse maternal and neonatal outcomes among obese pregnant women. This is a retrospective record review conducted on obese pregnant women who delivered in the last five years attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Therefore, for analysis we used the following; 1- descriptive analysis, 2- Chi-square test, Pearson correlation, independent t-test, and one-way ANOVA to test the difference in obese and adverse pregnancy outcomes. Advance statistics such as binary, and multinomial logistic regression were used to examine the relationship between obesity and all adverse pregnancy outcomes. A total of 1037 obese pregnant women were enrolled in our study including 620 (59.8%) obese in class I (30-34.9), 262 (25.3%) obese in class II (35-39.9), and 155 (14.9%) obese in class III (40). About 74.73% of the population were Saudis. The average age was 31.96 (5.79) years. Out of 1037 obese pregnant women, 449 did develop undesired antepartum outcomes, while 729 and 163 had adverse neonatal, and postpartum outcomes. Antepartum variables such as preeclampsia, gestational diabetes mellitus, impaired glucose tolerance test, antiphospholipid syndrome, premature rupture of membranes, placenta previa, anemia, urinary tract infection, and oligohydramnios, and rate of Cesarean section were significantly associated with obesity (P<0.05). Postpartum variables such as vaginal laceration, perianal laceration, postpartum hemorrhage, and endometritis were also significantly associated with obesity (P<0.05). Moreover, adverse neonatal outcomes such as low APGAR scores at 1 and 5 minutes, birthweight, gestational age, admission to neonatal intensive care unit, intrauterine fetal death, and neonatal death, were significant significantly associated with obesity (P<0.05). As our study demonstrated, maternal obesity resulted in adverse outcomes for the mother and fetus. Hence, to yield a better outcome for these women and their offspring, periconceptional counseling, conducting health education, and comprehensive plan prior to their pregnancy should be enforced.

Fallatah AM ，Babatin HM ，Nassibi KM ，Banweer MK ，Fayoumi MN ，Oraif AM ... -  《-》

Impact of aging on obstetric outcomes: defining advanced maternal age in Barcelona.

Claramonte Nieto M ，Meler Barrabes E ，Garcia Martínez S ，Gutiérrez Prat M ，Serra Zantop B ... -  《BMC Pregnancy and Childbirth》

Perspectives on risk: Assessment of risk profiles and outcomes among women planning community birth in the United States.

There is little agreement on who is a good candidate for community (home or birth center) birth in the United States. Data on n=47 394 midwife-attended, planned community births come from the Midwives Alliance of North America Statistics Project. Logistic regression quantified the independent contribution of 10 risk factors to maternal and neonatal outcomes. Risk factors included: primiparity, advanced maternal age, obesity, gestational diabetes, preeclampsia, postterm pregnancy, twins, breech presentation, history of cesarean and vaginal birth, and history of cesarean without history of vaginal birth. Models controlled additionally for Medicaid, race/ethnicity, and education. The independent contributions of maternal age and obesity were quite modest, with adjusted odds ratios (AOR) less than 2.0 for all outcomes: hospital transfer, cesarean, perineal trauma, postpartum hemorrhage, low/very-low Apgar, maternal or neonatal hospitalization, NICU admission, and fetal/neonatal death. Breech was strongly associated with morbidity and fetal/neonatal mortality (AOR 8.2, 95% CI, 3.7-18.4). Women with a history of both cesarean and vaginal birth fared better than primiparas across all outcomes; however, women with a history of cesarean but no prior vaginal births had poor outcomes, most notably fetal/neonatal demise (AOR 10.4, 95% CI, 4.8-22.6). Cesarean births were most common in the breech (44.7%), preeclampsia (30.6%), history of cesarean without vaginal birth (22.1%), and primipara (11.0%) groups. The outcomes of labor after cesarean in women with previous vaginal deliveries indicates that guidelines uniformly prohibiting labor after cesarean should be reconsidered for this subgroup. Breech presentation has the highest rate of adverse outcomes supporting management of vaginal breech labor in a hospital setting.

Bovbjerg ML ，Cheyney M ，Brown J ，Cox KJ ，Leeman L ... -  《-》

Endometriosis and adverse maternal, fetal and neonatal outcomes, a systematic review and meta-analysis.

Lalani S ，Choudhry AJ ，Firth B ，Bacal V ，Walker M ，Wen SW ，Singh S ，Amath A ，Hodge M ，Chen I ... -  《-》

Grand multiparity and the possible risk of adverse maternal and neonatal outcomes: a dilemma to be deciphered.

Al-Shaikh GK ，Ibrahim GH ，Fayed AA ，Al-Mandeel H ... -  《BMC Pregnancy and Childbirth》