Short term neonatal outcomes of pregnancies complicated by maternal obesity: is the risk higher for mothers with morbid obesity than for those with super morbid obesity?

Maternal obesity is of major factor that affects every aspect of maternity care. It is a concern for the health of at least 2 generations. 1 Godfrey KM Reynolds RM Prescott SL et al. Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol. 2017; 5: 53-64 Abstract Full Text Full Text PDF PubMed Scopus (549) Google Scholar ,2 Catalano PM Shankar K Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017; 356: j1 Crossref PubMed Scopus (574) Google Scholar For mothers, it increases the risk for pregnancy complications and, in the longer term, type 2 diabetes and cardiovascular disease. For infants, it increases the risks for congenital malformation, stillbirth, macrosomia, and developing childhood obesity and its later consequences. Therefore, maternal obesity is not only a public health challenge, but also a clinical concern in obstetrics. Recently, Dinsmoor et al 3 Dinsmoor MJ Ugwu LG Bailit JL et al. Short-term neonatal outcomes of pregnancies complicated by maternal obesity. Am J Obstet Gynecol MFM. 2023; 5100874 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar reported neonatal outcomes of pregnancies complicated by maternal obesity. The results were compared between women in the normal to overweight category (reference group, body mass index [BMI] 18.5–29.9 kg/m2) and those with obesity (BMI, 30–39.9 kg/m2), those with morbid obesity (MO) (BMI, 40–49.9 kg/m2), and those with super morbid obesity (SMO) (BMI, ≥50 kg/m2). A total of 2103 (4.0%) of 52,162 neonates had the composite outcome. Compared with the reference group, gravidas with MO but not those with obesity or SMO are at higher risk for composite neonatal morbidity. Obesity, preterm birth, and neonatal outcomesAmerican Journal of Obstetrics & Gynecology MFMVol. 5Issue 6PreviewWe thank Drs Lei and Li for their interest in our article entitled “Short term neonatal outcomes of pregnancies complicated by maternal obesity.”1 They correctly suggested that the increasing trend in preterm delivery rates among pregnant people with a higher body mass index (BMI) might bias our results toward more neonatal complications among those with more severe obesity. That is precisely why our multivariable model for composite neonatal morbidity included an adjustment for preterm birth (Table 3). Full-Text PDF