Objective: To study maternal obesity associated neonatal morbidities in the early newborn period at a single, large regional perinatal center
Background: Maternal obesity has been associated with pregnancy related complications and neonatal morbidities. The primary aim of this study was to evaluate early neonatal morbidities associated with maternal obesity from the mother-infant dyad data set at our center for the past decade.
Methods: After our institutional review board approval, we conducted a retrospective chart review of all mother-infant dyads born from 1/1/2009 to 12/31/2019 at Albany Medical Center, a large regional perinatal center in NY state, covering 21 counties and 18 hospitals. Maternal obesity was defined using NIH definition of pre-pregnancy BMI ≥30 Kg/m2. Maternal data included gestational diabetes, hypertension and mode of delivery. Neonatal data included birth weight, gestational age, and morbidities like need for respiratory support from delivery room, CPAP use, development of respiratory distress syndrome (RDS), neonatal hypoglycemia (NH), and hypoxic ischemic encephalopathy (HIE). Diagnosis of RDS, NH, and HIE were defined by on the service neonatologist and data system review neonatologist. Normally distributed continuous data were compared by t test while Chi square was used to compare the nominal data. Binary logistic regression was used to evaluate the effect of maternal obesity on respiratory distress while controlling for gestational age, birth weight, maternal diabetes and hypertension.
Results: Medical records of 23,143 infants and their mothers, delivered during the study period of 11 years were reviewed; 945 were excluded due to incomplete or missing data. Of the 22,198 mother-infant dyads included in the study, 7,200 infants (32.4%) were born to obese mothers and 14,998 infants (67.6%) were born to non-obese women. There was a statistically significant increase in gestational diabetes, gestational hypertension, and cesarean deliveries in obese mothers. Assisted ventilation after delivery, CPAP use and diagnosis of respiratory distress syndrome were significantly higher in infants born to obese mothers. Neonatal hypoglycemia diagnosis was also significantly higher in infants of obese mothers, but HIE incidence was similar in both groups, see table 1.
Conclusion: Obese mothers develop gestational diabetes and hypertension more frequently than non-obese women. Infants born to obese mothers are more likely to be delivered by cesarean section, and are at a higher risk of developing both, respiratory failure in delivery room and subsequent respiratory distress syndrome, and hypoglycemia in the early neonatal period. Public health education and prevention of obesity in women of childbearing age can have positive impact on maternal health and ameliorate neonatal morbidities.
