Seminars in Fetal & Neonatal Medicine
Volume 15, Issue 2 , Pages 94-99 , April 2010

Obesity in pregnancy: outcomes and economics

  • Ingrid Rowlands

      Affiliations

    • School of Medicine, University of Queensland, Brisbane, Australia
  • ,
  • Nick Graves

      Affiliations

    • Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
  • ,
  • Susan de Jersey

      Affiliations

    • Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Australia
  • ,
  • H. David McIntyre

      Affiliations

    • Mater Clinical School, School of Medicine, University of Queensland, Brisbane, Australia
  • ,
  • Leonie Callaway

      Affiliations

    • Royal Brisbane Clinical School, School of Medicine, University of Queensland, Brisbane, Australia
    • Corresponding Author InformationCorresponding author. Address: Level 7, Block 6, Royal Brisbane and Women's Hospital, Herston QLD 4029, Australia. Tel.: +61 7 3636 8111; fax: +61 7 3365 55811.

References 

  1. Confidential Enquiry into Maternal and Child Health (CEMACH) . Why mothers die. The sixth report into maternal deaths in the United Kingdom. London: RCOG Press; 2004;
  2. Callaway LK, Prins JB, Chang AM, et al. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust. 2006;184:56–59
  3. Lawlor DA, Smith GD, O'Callaghan M, et al. Epidemiologic evidence for the fetal overnutrition hypothesis: findings from the Mater-University study of pregnancy and its outcomes. Am J Epidemiol. 2006;
  4. O'Brien TE, Ray JG, Chan WS. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology. 2003;14:368–374
  5. James AH, Jamison MG, Brancazio LR, et al. Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol. 2006;194:1311–1315
  6. Maasilta P, Bachour A, Teramo K, et al. Sleep-related disordered breathing during pregnancy in obese women. Chest. 2001;120:1448–1454
  7. Hendler I, Schatz M, Momirova V, et al. Association of obesity with pulmonary and nonpulmonary complications of pregnancy in asthmatic women. Obstet Gynecol. 2006;108:77–82
  8. Ko CW, Beresford SA, Schulte SJ, et al. Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy. Hepatology. 2005;41:359–365
  9. Albert HB, Godskesen M, Korsholm L, et al. Risk factors in developing pregnancy-related pelvic girdle pain. Acta Obstet Gynecol Scand. 2006;85:539–544
  10. D'Alfonso A, Iovenitti P, Carta G. Urinary disorders during pregnancy and postpartum: our experience. Clin Exp Obstet Gynecol. 2006;33:23–25
  11. Heslehurst N, Simpson H, Ells LJ, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev. 2008;9:635–683
  12. Bodnar LM, Siega-Riz AM, Cogswell ME. High prepregnancy BMI increases the risk of postpartum anemia. Obes Res. 2004;12:941–948
  13. Sebire NJ, Jolly M, Harris JP, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord. 2001;25:1175–1182
  14. Hilson JA, Rasmussen KM, Kjolhede CL. Excessive weight gain during pregnancy is associated with earlier termination of breast-feeding among white women. J Nutr. 2006;136:140–146
  15. Li C, Kaur H, Choi WS, et al. Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight. Obes Res. 2005;13:362–371
  16. Jevitt C, Hernandez I, Groer M. Lactation complicated by overweight and obesity: supporting the mother and newborn. J Midwifery Women's Health. 2007;52:606–613
  17. Hediger ML, Overpeck MD, McGlynn A, et al. Growth and fatness at three to six years of age of children born small- or large-for-gestational age. Pediatrics. 1999;104:e33
  18. Amir LH, Donath S. A systematic review of maternal obesity and breastfeeding intention, initiation and duration. BMC Pregn Childbirth. 2007;7:9
  19. Denison FC, Price J, Graham C, et al. Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labour at term. Br J Obstet Gynaecol. 2008;115:720–725
  20. Kristensen J, Vestergaard M, Wisborg K, et al. Pre-pregnancy weight and the risk of stillbirth and neonatal death. Br J Obstet Gynaecol. 2005;112:403–408
  21. Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004;103:219–224
  22. Juhasz G, Gyamfi C, Gyamfi P, et al. Effect of body mass index and excessive weight gain on success of vaginal birth after cesarean delivery. Obstet Gynecol. 2005;106:741–746
  23. Saravanakumar K, Rao SG, Cooper GM. Obesity and obstetric anaesthesia. Anaesthesia. 2006;61:36–48
  24. Catalano PM, Ehrenberg HM. The short- and long-term implications of maternal obesity on the mother and her offspring. Br J Obstet Gynaecol. 2006;113:1126–1133
  25. Weiss JL, Malone FD, Emig D, et al. Obesity, obstetric complications and cesarean delivery rate – a population-based screening study. Am J Obstet Gynecol. 2004;190:1091–1097
  26. Surkan PJ, Hsieh CC, Johansson AL, et al. Reasons for increasing trends in large for gestational age births. Obstet Gynecol. 2004;104:720–726
  27. Kramer MS, Morin I, Yang H, et al. Why are babies getting bigger? Temporal trends in fetal growth and its determinants. J Pediatr. 2002;141:538–542
  28. Ehrenberg HM, Huston-Presley L, Catalano PM. The influence of obesity and gestational diabetes mellitus on accretion and the distribution of adipose tissue in pregnancy. Am J Obstet Gynecol. 2003;189:944–948
  29. Ehrenberg HM, Mercer BM, Catalano PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol. 2004;191:964–968
  30. Gross T, Sokol RJ, King KC. Obesity in pregnancy: risks and outcome. Obstet Gynecol. 1980;56:446–450
  31. Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health. 2001;91:436–440
  32. Kumari AS. Pregnancy outcome in women with morbid obesity. Int J Gynaecol Obstet. 2001;73:101–107
  33. Chu SY, Kim SY, Lau J, et al. Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol. 2007;197:223–228
  34. Nohr EA, Bech BH, Davies MJ, et al. Prepregnancy obesity and fetal death: a study within the Danish National Birth Cohort. Obstet Gynecol. 2005;106:250–259
  35. Cnattingius S, Bergstrom R, Lipworth L, et al. Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med. 1998;338:147–152
  36. Stothard KJ, Tennant PW, Bell R, et al. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. J Am Med Assoc. 2009;301:636–650
  37. Werler MM, Louik C, Shapiro S, et al. Prepregnant weight in relation to risk of neural tube defects. J Am Med Assoc. 1996;275:1089–1092
  38. Cedergren MI, Kallen BA. Maternal obesity and infant heart defects. Obes Res. 2003;11:1065–1071
  39. Martinez-Frias ML, Frias JP, Bermejo E, et al. Pre-gestational maternal body mass index predicts an increased risk of congenital malformations in infants of mothers with gestational diabetes. Diabet Med. 2005;22:775–781
  40. Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics. 2004;114:e29–e36
  41. Martorell R, Stein AD, Schroeder DG. Early nutrition and later adiposity. J Nutr. 2001;131:874S–880S
  42. Hull HR, Dinger MK, Knehans AW, et al. Impact of maternal body mass index on neonate birthweight and body composition. Am J Obstet Gynecol. 2008;198:416.e1–416.e6
  43. Galtier-Dereure F, Boegner C, Bringer J. Obesity and pregnancy: complications and cost. Am J Clin Nutr. 2000;71:1242S–1248S
  44. Heslehurst N, Lang R, Rankin J, et al. Obesity in pregnancy: a study of the impact of maternal obesity on NHS maternity services. Br J Obstet Gynaecol. 2007;114:334–342
  45. Chu SY, Bachman DJ, Callaghan WM, et al. Association between obesity during pregnancy and increased use of health care. N Engl J Med. 2008;358:1444–1453
  46. Johnson K, Posner SF, Biermann J, et al. Recommendations to improve preconception health and health care – United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR Recomm Rep. 2006;55:1–23
  47. Rosenfeld JA, Everett KD. Factors related to planned and unplanned pregnancies. J Fam Pract. 1996;43:161–166
  48. Knudsen VK, Orozova-Bekkevold I, Rasmussen LB, et al. Low compliance with recommendations on folic acid use in relation to pregnancy: is there a need for fortification?. Public Health Nutr. 2004;7:843–850
  49. Willhoite MB, Bennert HW, Palomaki GE, et al. The impact of preconception counseling on pregnancy outcomes. The experience of the Maine Diabetes in Pregnancy Program. Diabetes Care. 1993;16:450–455
  50. Galuska DA, Will JC, Serdula MK, et al. Are health care professionals advising obese patients to lose weight?. J Am Med Assoc. 1999;282:1576–1578
  51. Snow V, Barry P, Fitterman N, et al. Pharmacologic and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2005;142:525–531
  52. Dixon JB, Dixon ME, O'Brien PE. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol. 2005;106:965–972
  53. Young KR. Routine weighing during antenatal visits. Br Med J. 1992;304:1308–1309
  54. Krishnamoorthy U, Schram CM, Hill SR. Maternal obesity in pregnancy: is it time for meaningful research to inform preventive and management strategies?. Br J Obstet Gynaecol. 2006;113:1134–1140
  55. American College of Obstetricians and Gynaecologists. Committee Opinion Number 315: Obesity in Pregnancy. 2005.
  56. Institute of Medicine . Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academy Press; 2009;
  57. Gore SA, Brown DM, West DS. The role of postpartum weight retention in obesity among women: a review of the evidence. Ann Behav Med. 2003;26:149–159
  58. Birdsall KM, Vyas S, Khazaezadeh N, et al. Maternal obesity: a review of interventions. Int J Clin Pract. 2009;63:494–507
  59. Thornton YS, Smarkola C, Kopacz SM, et al. Perinatal outcomes in nutritionally monitored obese pregnant women: a randomized clinical trial. J Natl Med Assoc. 2009;101:569–577
  60. Wolff S, Legarth J, Vangsgaard K, et al. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes (Lond). 2008;32:495–501
  61. Dodd JM, Crowther CA, Robinson JS. Dietary and lifestyle interventions to limit weight gain during pregnancy for obese or overweight women: a systematic review. Acta Obstet Gynecol Scand. 2008;87:702–706
  62. King T, Kavanagh AM, Jolley D, et al. Weight and place: a multilevel cross-sectional survey of area-level social disadvantage and overweight/obesity in Australia. Int J Obes (Lond). 2006;30:281–287
  63. Catalano PM. Management of obesity in pregnancy. Obstet Gynecol. 2007;109:419–433
  64. Glazer NL, Hendrickson AF, Schellenbaum GD, et al. Weight change and the risk of gestational diabetes in obese women. Epidemiology. 2004;15:733–737
  65. Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 2006;368:1164–1170
  66. Faddy MJ, Graves N, Pettitt A. Modelling length of stay in hospital and other right skewed data: comparison of phase-type, gamma and log-normal distributions. Value in Health. 2008;12:309–314
  67. Graves N, Weinhold D, Birrell F, et al. The effect of healthcare-acquired infection on length of hospital stay and cost. Infect Control Hosp Epidemiol. 2007;28:280–292
  68. Brazier J, Deverill M, Green C, et al. A review of the use of health status measures in economic evaluation. Health Technol Assess. 1999;3(9):1–164
  69. Samuelson PA. Economics. New York: McGraw Hill; 1976;
  70. Cookson R. Willingness to pay methods in health care: a sceptical view. Health Econ. 2003;12:891–894
  71. Shiroiwa T, Sung YK, Fukuda T, et al. International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?. Health Econ. 2009 Apr 20;[Epub ahead of print]
  72. Halton K, Graves N. Economics of preventing catheter-related bloodstream infection?. Emerg Infect Dis. 2007;13:815–823
  73. Caldwell DMA, Ades AE, Higgins JPT. Simultaneous comparison of multiple treatments: combining direct and indirect evidence. Br Med J. 2005;331:897–900
  74. Sculpher MJ, Claxton K, Drummond M, et al. Whither trial-based economic evaluation for health care decision making?. Health Econ. 2006;15:677–687
  75. Kuntz K, Weinstein M. Modelling in economic evaluation. Ch. 7. In:  Drummond M,  McGuire A editor. Economic evaluation in health care. Merging theory with practice. Oxford: Oxford University Press; 2001;

PII: S1744-165X(09)00089-4

doi: 10.1016/j.siny.2009.09.003

Seminars in Fetal & Neonatal Medicine
Volume 15, Issue 2 , Pages 94-99 , April 2010