Obstetric outcomes in overweight and obese adolescents.

Abstract

Obese adult pregnant women have increased rates of maternal and neonatal complications. Our objective was to examine adverse obstetric outcomes in overweight adolescent women. In a retrospective case-control study of 4822 women who were < 19 years old, 3324 appropriate-weight subjects (body mass index, 18.5-24.9 kg/m2) and 1498 overweight subjects (body mass index, > or = 25 kg/m2) were compared. Frequencies and odds ratios for adverse maternal or neonatal events were computed. Compared with appropriate-weight adolescents, primary cesarean delivery (odds ratio, 1.6; 95% CI, 1.4-1.9), failure to progress/cephalopelvic disproportion (odds ratio 1.6; 95% CI, 1.3-1.9), labor induction (odds ratio, 1.4; 95% CI, 1.3-1.7), pregnancy-induced hypertension (odds ratio, 1.8; 95% CI, 1.4-2.3), preeclampsia (odds ratio, 1.7; 95% CI, 1.2-2.4), and gestational diabetes mellitus (odds ratio, 3.0, 95% CI, 1.6-5.4) were significantly more common in overweight adolescents. Significant neonatal findings included an increased incidence of macrosomia (odds ratio, 1.6; 95% CI, 1.2-2.0) and a decreased incidence of low birth weight infants (odds ratio, 0.6; 95% CI, 0.4-0.8) and small for gestational age infants (odds ratio, 0.8; 95% CI, 0.7-1.0). Overweight adolescent women are at increased risk for adverse neonatal and perinatal outcomes. With rates of overweight increasing overall, overweight in the gravid adolescent is a pressing perinatal and public health concern.