ArticleArchives of gynecology and obstetrics2025
Association between obesity in women with multiple gestations and adverse obstetric outcomes: a study of an American population database with over 136,000 unique deliveries.
Article in Archives of gynecology and obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe purpose of this study is to compare obese and non-obese women with multiple pregnancies to determine the effects on pregnancy, delivery, and neonatal outcomes.
methodsWe conducted a retrospective population-based study utilizing data collected between 2004 and 2014 inclusively, from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. A total of 137,303 multiple pregnancies were analyzed; 130,542 (95%) were non-obese, while 6761 (5%) were obese. An initial analysis was performed to identify the prevalence of obesity in women with multiple pregnancies. Subsequently, chi-square tests and binary logistic regression analyses were conducted to assess the association between obesity and multiple gestation in the context of obstetric complications.
resultsThere was a statistically significant increase in the prevalence of obesity for women with multiple gestations (p < 0.0001). The obese group was at higher risk of pregnancy-induced hypertension (adjusted odd's ratio [aOR] = 1.89, 95% confidence interval [CI] = 1.77-2.02), gestational hypertension (aOR = 1.84, CI = 1.65-2.05), preeclampsia (aOR = 1.68, CI = 1.55-1.81), preeclampsia or eclampsia superimposed on pre-existing hypertension (aOR = 1.86, CI = 1.58-2.20), gestational diabetes mellitus (aOR = 2.65, CI = 2.44-2.87), and placenta previa (aOR = 0.57, CI = 0.39-0.85). They were more likely to have preterm premature rupture of membranes (aOR = 1.19, CI = 1.06-1.34), chorioamnionitis (aOR = 1.24, CI = 1.03-1.51), caesarean deliveries (aOR = 1.28, CI = 1.18-1.38), wound complications (aOR = 1.65, CI = 1.31-2.08), and transfusions (aOR = 0.77, CI = 0.67-0.89). They were less likely to have small for gestational age neonates (aOR = 0.88, CI = 0.79-0.97), though more likely to have neonates with congenital anomalies (aOR = 1.56, CI = 1.16-2.10).
conclusionObesity and multiple gestations are independent risk factors for adverse obstetric outcomes. Combined, when analyzed in a large population, obesity in multiple gestation increases the risk of maternal, delivery, and neonatal complications.
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