ArticleAmerican journal of obstetrics & gynecology MFM2021
Severe maternal morbidity and mortality during delivery hospitalization of class I, II, III, and super obese women.
Article in American journal of obstetrics & gynecology MFM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 29 citations in OpenAlex.
- Maternal Adiposity and Inflammation: Risk Factors for Iron Deficiency in Pregnancy.The Journal of nutrition · 2025Trial
- GLP-1 Receptor Agonist Exposure During Pregnancy: A Systematic Review and Meta-Analysis of Adverse Pregnancy Outcomes.JACC. Advances · 2026Article
- Perinatal obesity primes the hepatic metabolic stress response in the offspring across life span.Scientific reports · 2025Article
- Association between Adiposity and Iron Status in Women of Reproductive Age: Data from the UK National Diet and Nutrition Survey (NDNS) 2008-2019.The Journal of nutrition · 2024Article
- Obesity at term: What to consider? How to deliver?Archives of gynecology and obstetrics · 2024Review
- Obesity in prenatal medicine: a game changer?Archives of gynecology and obstetrics · 2024Review
- Maternal diet during pregnancy and adaptive changes in the maternal and fetal pancreas have implications for future metabolic health.Frontiers in endocrinology · 2024Review
- Observational
- Early life programming of health and disease: The long-term consequences of obesity in pregnancy.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2022Review
- Association of Prepregnancy Body Mass Index With Risk of Severe Maternal Morbidity and Mortality Among Medicaid Beneficiaries.JAMA network open · 2022Article
- Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2022Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPrevious studies show that obesity predisposes patients to higher risks of adverse pregnancy outcomes. Data on the relationship between increasing degrees of obesity and risks of severe maternal morbidity, including mortality, are limited.
objectiveWe examined the association of increasing classes of obesity, especially super obesity, with the risk of severe maternal morbidity and mortality at the time of delivery hospitalization. STUDY
designUsing New York City linked birth certificates and hospital discharge data, we conducted a retrospective cohort study. This study identified delivery hospitalizations for singleton, live births in 2008-2012. Women were classified as having obesity (class I, II, III, or super obesity), as opposed to normal weight or overweight, based on prepregnancy body mass index. Cases of severe maternal morbidity were identified based on International Classification of Diseases, Ninth Revision diagnosis and procedure codes according to Centers for Disease Control and Prevention criteria. Multivariable logistic regression was used to evaluate the association between obesity classes and severe maternal morbidity, adjusting for maternal sociodemographic characteristics.
resultsDuring 2008-2012, there were 570,997 live singleton births with available information on prepregnancy body mass index that met all inclusion criteria. After adjusting for maternal characteristics, women with class II (adjusted odds ratio, 1.14; 95% confidence interval, 1.05-1.23), class III (adjusted odds ratio, 1.34; 95% confidence interval, 1.21-1.49), and super obesity (adjusted odds ratio, 1.99; 95% confidence interval, 1.57-2.54) were all significantly more likely to have severe maternal morbidity than normal and overweight women. Super obesity was associated with specific severe maternal morbidity indicators, including renal failure, air and thrombotic embolism, blood transfusion, heart failure, and the need for mechanical ventilation.
conclusionThere is a significant dose-response relationship between increasing obesity class and the risk of severe maternal morbidity at delivery hospitalization. The risks of severe maternal morbidity are highest for women with super obesity. Given that this is a modifiable risk factor, women with prepregnancy obesity should be counseled on the specific risks associated with pregnancy before conception to optimize their pregnancy outcomes.
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