Prevalence and Associated Risk Factors for Obesity During Pregnancy Over Time

 

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Abstract

Objective: The increasing prevalence of obesity is having an impact on morbidity worldwide. Since young mature women are equally affected by the general increase in weight, the aim of the study was to evaluate the prevalence of obesity together with associated maternal risk factors, complications during pregnancy, and fetal outcomes in a local cohort for the years 2006 and 2011. Study Design: Maternal and fetal records of women who delivered at the University of Würzburg, with a 5-year interval (2006 and 2011) between investigations, were retrospectively analyzed. Descriptive statistics included prevalence of obesity, maternal weight gain, as well as several complications during pregnancy and fetal characteristics. The association between maternal or fetal complications and extent of maternal obesity was analyzed. Results: Our analysis included 2838 mothers with singleton pregnancies who delivered in 2006 (n = 1293) or 2011 (n = 1545) in our department. We found that neither pre-pregnancy body mass index (23.77 ± 4.85 vs. 24.09 ± 5.10 kg/m², p = 0.25) nor weight gain (14.41 ± 5.77 vs. 14.78 ± 5.65 kg; p = 0.09) increased significantly over time. But the majority of all overweight (71 %) or obese (60.4 %) mothers gained more weight than generally recommended. The prevalence of gestational diabetes, gestational hypertension, and preeclampsia increased significantly and was associated with high pre-pregnancy body mass index, as was delivery by cesarean section. However, obesity was not associated with prolonged pregnancy and did not seem to negatively affect fetal outcome. Conclusion: There is a trend to increasing weight gain during pregnancy, and the majority of mothers, especially those with a high pre-pregnancy body mass index, exceeded the weight gain recommendations. Associated risk factors such as gestational diabetes, hypertension, and delivery by cesarean section are increasing.

Zusammenfassung

Einleitung: Die steigende Prävalenz adipöser Menschen führt weltweit zu einer relevanten Morbidität, die auch junge Frauen im geschlechtsreifen Alter betrifft. Damit gerät der Themenkomplex Adipositas und assoziierte Komplikationen auch in Hinblick auf die Versorgung schwangerer Frauen in den Fokus. Das Ziel dieser Arbeit war es deshalb, die Adipositasprävalenz und hiermit assoziierte maternale und fetale Risikofaktoren zwischen 2006 und 2011 in einem lokalen Kollektiv zu untersuchen. Material und Methoden: Die retrospektive Analyse umfasste alle maternalen und fetalen Daten von Patientinnen, die 2006 und 2011 an der Universitäts-Frauenklinik Würzburg von einem Einling entbunden wurden. Die deskriptive Statistik umfasste die Prävalenz von Adipositas und Gewichtszunahme, sowie maternale Risikofaktoren, Schwangerschaftskomplikationen und fetales Outcome. Weiterhin wurde eine Assoziation von maternalen und fetalen Komplikationen in Abhängigkeit vom Grad der Adipositas untersucht. Ergebnisse: Unsere Analyse umfasste 2838 Patientinnen mit Einlingsgraviditäten, die in den Jahren 2006 (n = 1293) und 2011 (n = 1545) an der Universitätsklinik Würzburg entbunden haben. Es zeigte sich, dass weder der initiale BMI (23,77 ± 4,85 vs. 24,09 ± 5,10 kg/m², p = 0,25) noch die Gewichtszunahme während der Schwangerschaft (14,41 ± 5,77 vs. 14,78 ± 5,65 kg; p = 0,09) zwischen 2006 und 2011 signifikant anstiegen. Die Mehrheit der übergewichtigen (71 %) oder adipösen (60,4 %) Patientinnen überstieg die empfohlene Gewichtszunahme. Die Prävalenz von adipositasassoziierten Erkrankungen wie Gestationsdiabetes, präexistenter Hypertonus sowie Präeklampsie stiegen signifikant an und waren mit einem hohen initialen Body-Mass-Index assoziiert. Während Übergewichtigkeit nicht mit einer Terminüberschreitung assoziiert war, wurden adipöse Patientinnen signifikant häufiger per Sectio caesarea entbunden. Das Geburtsgewicht war 2011 signifikant höher als 2006, wobei keine signifikanten Änderungen im fetalen Outcome dargestellt werden konnten. Schlussfolgerung: Es gibt einen Trend zu vermehrter Gewichtszunahme während der Schwangerschaft. Assoziierte Risikofaktoren wie Gestationsdiabetes, Hypertonus und Kaiserschnittentbindung sind erhöht.

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