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The impact of parity and maternal obesity on the fetal outcomes of a non-selected Lower Saxony population

  • Lars Brodowski EMAIL logo , Niels Rochow , Efrah I. Yousuf , Fabian Kohls , Constantin S. von Kaisenberg , Silvia Berlage and Manfred Voigt
Published/Copyright: October 26, 2021
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 50 Issue 2

Abstract

Objectives

Maternal obesity during pregnancy is associated with adverse intrauterine events and fetal outcomes and may increase the risk of obesity and metabolic disease development in offspring. Higher parity, regardless of socioeconomic status, is associated with increased maternal body mass index (BMI). In this study, we examined the relationship between parity, maternal obesity, and fetal outcomes in a large sample of mother-neonate pairs from Lower Saxony, Germany.

Methods

This retrospective cohort study examined pseudonymized data of a non-selected singleton cohort from Lower Saxony’s statewide quality assurance initiative. 448,963 cases were included. Newborn outcomes were assessed in relation to maternal BMI and parity.

Results

Maternal obesity was associated with an increased risk of placental insufficiency, chorioamnionitis, and fetal distress while giving birth. This effect was present across all parity groups. Fetal presentation did not differ between BMI groups, except for the increased risk of high longitudinal position and shoulder dystocia in obese women. Maternal obesity was also associated with an increased risk of premature birth, low arterial cord blood pH and low 5-min APGAR scores.

Conclusions

Maternal obesity increases the risk of adverse neonatal outcomes. There is a positive correlation between parity and increased maternal BMI. Weight-dependent fetal risk factors increase with parity, while parity-dependent outcomes occur less frequently in multipara. Prevention and intervention programs for women planning to become pregnant can be promising measures to reduce pregnancy and birth complications.

Keywords: fetal outcome; obesity; parity; pregnancy
Corresponding author: Dr. med. Lars Brodowski, Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Carl-Neuberg-Str. 1 30625 Hannover, Germany, E-mail:

Acknowledgments

The authors greatly appreciate the support of the obstetric hospitals in Lower Saxony and the Ärztekammer Niedersachsen in recruiting participants and providing data.

  1. Research funding: None declared.

  2. Author contributions: Conceived and concepted the study: LB CVK MV FK. Study design: LB NR MV. Supervision: LB FK CVK FK SB MV. Analyzed the data: MV NR. Contributed patient information/analysis tools: SB MV NR. Contributed to the writing of the manuscript: LB NR EIY. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: This is a retrospective analysis of birth data from the Lower Saxony Perinatal Survey under the Ethical Approval of the Ethics Committee of the Lower Saxony Medical Association.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2020-0614).

Received: 2020-12-31
Accepted: 2021-10-05
Published Online: 2021-10-26
Published in Print: 2022-02-23

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Corner of Academy
  3. External cephalic version in the outpatient clinic
  4. Original Articles – Obstetrics
  5. How COVID-19 pandemic is changing the practice of prenatal screening and diagnosis?
  6. Analysis of prevalence and sociodemographic conditions among women in labor with and without COVID-19 in public hospitals in Chile
  7. Influence of Covid-19 infection on fetal thymus size after recovery
  8. Second trimester fetal thymus size in association to preterm birth
  9. Heat stable carbetocin vs. oxytocin for the prevention of post-partum hemorrhage in emergency caesarean delivery: a randomized controlled trial
  10. Enhanced S100B expression in T and B lymphocytes in spontaneous preterm birth and preeclampsia
  11. The impact of parity and maternal obesity on the fetal outcomes of a non-selected Lower Saxony population
  12. Importance of frame rate for the measurement of strain and synchrony in fetuses using speckle tracking echocardiography
  13. Kidney graft function before pregnancy as a predictor of graft, maternal and fetal outcomes in pregnant renal transplant recipients
  14. Sociodemographic factors affecting perceived stress during pregnancy and the association with immune-mediator concentrations
  15. Original Articles – Neonates
  16. Smoking influence on early and late fetal growth
  17. Maternal oxytocin administration modulates gene expression in the brains of perinatal mice
  18. Original Articles – Fetus
  19. Human epididymis protein 4 and fetal lung maturity
  20. Commentary
  21. Plato unmasks hidden limits of tele-education
  22. Letter to the Editors
  23. COVID-19 delta variant and anxiety and fear in pregnant women
  24. Reply to: COVID-19 Delta variant and anxiety and fear in pregnant women
  25. COVID-19 infected pregnant women and cardiotocographic features
  26. Letter Reply
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https://doi.org/10.1515/jpm-2020-0614
Keywords for this article
fetal outcome; obesity; parity; pregnancy

Articles in the same Issue

  1. Frontmatter
  2. Corner of Academy
  3. External cephalic version in the outpatient clinic
  4. Original Articles – Obstetrics
  5. How COVID-19 pandemic is changing the practice of prenatal screening and diagnosis?
  6. Analysis of prevalence and sociodemographic conditions among women in labor with and without COVID-19 in public hospitals in Chile
  7. Influence of Covid-19 infection on fetal thymus size after recovery
  8. Second trimester fetal thymus size in association to preterm birth
  9. Heat stable carbetocin vs. oxytocin for the prevention of post-partum hemorrhage in emergency caesarean delivery: a randomized controlled trial
  10. Enhanced S100B expression in T and B lymphocytes in spontaneous preterm birth and preeclampsia
  11. The impact of parity and maternal obesity on the fetal outcomes of a non-selected Lower Saxony population
  12. Importance of frame rate for the measurement of strain and synchrony in fetuses using speckle tracking echocardiography
  13. Kidney graft function before pregnancy as a predictor of graft, maternal and fetal outcomes in pregnant renal transplant recipients
  14. Sociodemographic factors affecting perceived stress during pregnancy and the association with immune-mediator concentrations
  15. Original Articles – Neonates
  16. Smoking influence on early and late fetal growth
  17. Maternal oxytocin administration modulates gene expression in the brains of perinatal mice
  18. Original Articles – Fetus
  19. Human epididymis protein 4 and fetal lung maturity
  20. Commentary
  21. Plato unmasks hidden limits of tele-education
  22. Letter to the Editors
  23. COVID-19 delta variant and anxiety and fear in pregnant women
  24. Reply to: COVID-19 Delta variant and anxiety and fear in pregnant women
  25. COVID-19 infected pregnant women and cardiotocographic features
  26. Letter Reply
  27. Response to the concern that the baseline change in CTG traces does not reflect the impact of maternal COVID-19
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