Connect
MJA
MJA

The prevalence and impact of overweight and obesity in an Australian obstetric population

Leonie K Callaway, Allan M Chang, H David McIntyre and Johannes B Prins
Med J Aust 2006; 184 (2): 56-59.

Summary

Objective: To assess the prevalence and impact of overweight and obesity in an Australian obstetric population.

Design, setting and participants: The Mater Mother’s Hospital (MMH), South Brisbane, is an urban tertiary referral maternity hospital. We reviewed data for the 18 401 women who were booked for antenatal care at the MMH, delivered between January 1998 and December 2002, and had a singleton pregnancy. Of those women, 14 230 had an estimated pre-pregnancy body mass index (BMI) noted in their record; 2978 women with BMI ≤ 20 kg/m2 were excluded from further study; the remaining 11 252 women were divided into four categories: “normal” (BMI 20.01–25 kg/m2), “overweight” (BMI 25.01–30 kg/m2), “obese” (BMI 30.01–40 kg/m2) and “morbidly obese” (BMI > 40 kg/m2).

Main outcome measures: Prevalence of overweight and obesity in an obstetric population; maternal, peripartum and neonatal outcomes associated with raised BMI.

Results: Of the 14 230 women, 6443 (45%) were of normal weight, and 4809 (34%) were overweight, obese or morbidly obese. Overweight, obese and morbidly obese women were at increased risk of adverse outcomes (figures represent adjusted odds ratio [AOR] [95% CI]): hypertensive disorders of pregnancy (overweight 1.74 [1.45–2.15], obese 3.00 [2.40–3.74], morbidly obese 4.87 [3.27–7.24]); gestational diabetes (overweight 1.78 [1.25–2.52], obese 2.95 [2.05–4.25], morbidly obese 7.44 [4.42–12.54]); hospital admission longer than 5 days (overweight 1.36 [1.13–1.63], obese 1.49 [1.21–1.86], morbidly obese 3.18 [2.19–4.61]); and caesarean section (overweight 1.50 [1.36–1.66], obese 2.02 [1.79–2.29], morbidly obese 2.54 [1.94–3.32]). Neonates born to obese and morbidly obese women had an increased risk of birth defects (obese 1.58 [1.02–2.46], morbidly obese 3.41 [1.67–6.94]); and hypoglycaemia (obese 2.57 [1.39–4.78], morbidly obese 7.14 [3.04–16.74]). Neonates born to morbidly obese women were at increased risk of admission to intensive care (2.77 [1.81–4.25]); premature delivery (< 34 weeks’ gestation) (2.13 [1.13–4.01]); and jaundice (1.44 [1.09–1.89]).

Conclusions: Overweight and obesity are common in pregnant women. Increasing BMI is associated with maternal and neonatal outcomes that may increase the costs of obstetric care. To assist in planning health service delivery, we believe that BMI should be routinely recorded on perinatal data collection sheets.

Please login with your free MJA account to view this article in full

  • Leonie K Callaway1
  • Allan M Chang2
  • H David McIntyre3
  • Johannes B Prins4

  • 1 Mater Hospital, South Brisbane, QLD.
  • 2 Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Woolloongabba, QLD.

Correspondence: 

Acknowledgements: 

We would like to thank Ms Liz Hollingshead, Information Management Officer, MMH, for assistance in accessing the data for our study. Leonie Callaway is the recipient of a National Health and Medical Research Council Postgraduate Medical Scholarship.

Competing interests:

None identified.

  • 1. Cameron AJ, Welborn TA, Zimmet PZ, et al. Overweight and obesity in Australia: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust 2003; 178: 427-432. <MJA full text>
  • 2. Wolfe H. High prepregnancy body-mass index — a maternal–fetal risk factor. N Engl J Med 1998; 338: 191-192.
  • 3. Sibai BM, Gordon T, Thom E, et al. Risk factors for preeclampsia in healthy nulliparous women: a prospective multicenter study. The National Institute of Child Health and Human Development Network of Maternal–Fetal Medicine Units. Am J Obstet Gynecol 1995; 172(2 Pt 1): 642-648.
  • 4. Ness RB, Roberts JM. Heterogeneous causes constituting the single syndrome of preeclampsia: a hypothesis and its implications. Am J Obstet Gynecol 1996; 175: 1365-1370.
  • 5. Wolfe HM, Zador IE, Gross TL, et al. The clinical utility of maternal body mass index in pregnancy. Am J Obstet Gynecol 1991; 164(5 Pt 1): 1306-1310.
  • 6. Stone JL, Lockwood CJ, Berkowitz GS, et al. Risk factors for severe preeclampsia. Obstet Gynecol 1994; 83: 357-361.
  • 7. Kaiser PS, Kirby RS. Obesity as a risk factor for cesarean in a low-risk population. Obstet Gynecol 2001; 97: 39-43.
  • 8. Young TK, Woodmansee B. Factors that are associated with cesarean delivery in a large private practice: the importance of prepregnancy body mass index and weight gain. Am J Obstet Gynecol 2002; 187: 312-318; discussion 318-320.
  • 9. Ehrenberg HM, Durnwald CP, Catalano P, Mercer BM. The influence of obesity and diabetes on the risk of cesarean delivery. Am J Obstet Gynecol 2004; 191: 969-974.
  • 10. Galtier-Dereure F, Boegner C, Bringer J. Obesity and pregnancy: complications and cost. Am J Clin Nutr 2000; 71(5 Suppl): S1242-S1248.
  • 11. Cnattingius S, Bergstrom R, Lipworth L, Kramer MS. Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998; 338: 147-152.
  • 12. Rosenberg TJ, Garbers S, Chavkin W, Chiasson MA. Prepregnancy weight and adverse perinatal outcomes in an ethnically diverse population. Obstet Gynecol 2003; 102(5 Pt 1): 1022-1027.
  • 13. Calandra C, Abell DA, Beischer NA. Maternal obesity in pregnancy. Obstet Gynecol 1981; 57: 8-12.
  • 14. Management of hypertension in pregnancy: executive summary. Australasian Society for the Study of Hypertension in Pregnancy. Med J Aust 1993; 158: 700-702.
  • 15. Hoffman L, Nolan C, Wilson JD, et al. Gestational diabetes mellitus — management guidelines. The Australasian Diabetes in Pregnancy Society. Med J Aust 1998; 169: 93-97. <MJA full text>
  • 16. Report of the Queensland Maternal and Perinatal Quality Council 2003. Brisbane: Queensland Government, 2004.
  • 17. Polley BA, Wing RR, Sims CJ. Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord 2002; 26: 1494-1502.
  • 18. Moses RG, Colagiuri S. The extent of undiagnosed gestational diabetes mellitus in New South Wales. Med J Aust 1997; 167: 14-16. <MJA full text>
  • 19. Moses RG, Webb AJ, Comber CD. Gestational diabetes mellitus: accuracy of Midwives Data Collection. Med J Aust 2003; 179: 218-219. <MJA full text>
  • 20. Stone CA, McLachlan KA, et al. Gestational diabetes in Victoria in 1996: incidence, risk factors and outcomes. Med J Aust 2002; 177: 486-491. <MJA full text>
  • 21. 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.
  • 22. Mamun AA, Lawlor DA, O’Callaghan MJ, et al. Family and early life factors associated with changes in overweight status between ages 5 and 14 years: findings from the Mater University Study of Pregnancy and its outcomes. Int J Obes Relat Metab Disord 2005; 29: 475-482.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.