Association between maternal body mass index during pregnancy, short‐term morbidity, and increased health service costs: a population‐based study. (18th September 2013)

• Record Type: Journal Article
• Authors: Denison, FC; Norwood, P; Bhattacharya, S; Duffy, A; Mahmood, T; Morris, C; Raja, EA; Norman, JE; Lee, AJ; Scotland, G
• Is Part Of: BJOG. Volume 121:Number 1(2014:Jan.)
• Page Start: 72
• Page End: 82
• Publication Date: 2013-09-18
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12443
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12443-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12443-sec-0001" sec-type="section"> <title>Objective</title> <p>To investigate the impact of maternal body mass index (BMI, kg/m<sup>2</sup>) on clinical complications, inpatient admissions, and additional short‐term costs to the National Health Service (NHS) in Scotland.</p> </sec> <sec id="bjo12443-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective cohort study using an unselected population database.</p> </sec> <sec id="bjo12443-sec-0003" sec-type="section"> <title>Setting</title> <p>Obstetric units in Scotland, 2003–2010.</p> </sec> <sec id="bjo12443-sec-0004" sec-type="section"> <title>Population</title> <p>A total of 124 280 singleton deliveries in 109 592 women with a maternal BMI recorded prior to 16 weeks of gestation.</p> </sec> <sec id="bjo12443-sec-0005" sec-type="section"> <title>Methods</title> <p>Population‐based retrospective cohort study of singleton deliveries, with multivariable analysis used to assess short‐term morbidity and health service costs.</p> </sec> <sec id="bjo12443-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Maternal and offspring outcomes, number and duration of hospital admissions, and healthcare costs.</p> </sec> <sec id="bjo12443-sec-0007" sec-type="section"> <title>Results</title> <p>Using multivariable analysis, in comparison with women of normal weight, women who were overweight, obese, or severely obese had an increased risk of essential hypertension [1.87 (1.18–2.96), 11.90 (7.18–19.72), and 36.10 (18.33–71.10)], pregnancy‐induced hypertension [1.76 (1.60–1.95), 2.98 (2.65–3.36), and 4.48 (3.57–5.63)], gestational diabetes [3.39 (2.30–4.99), 11.90 (7.54–18.79), and 67.40 (37.84–120.03)], emergency caesarean section [1.94 (1.71–2.21), 3.40 (2.91–3.96), and 14.34 (9.38–21.94)], and elective caesarean section [2.06 (1.84–2.30), 4.61 (4.06–5.24), and 17.92 (13.20–24.34)]. Compared with women of normal weight, women who were underweight, overweight, obese, or severely obese were associated with an 8, 16, 45, and 88% increase in the number of admissions, respectively, and women who were overweight, obese, or severely obese were associated with a 4, 9, and 12% increase in the duration of stay (all <italic>P </italic>< 0.001). The additional maternity costs [mean (95% CI), adjusted analyses] for women who were underweight, overweight, obese, or severely obese were £102.27 (£48.49–156.06), £59.89 (£41.61–78.17), £202.46 (£178.61–226.31), and £350.75 (£284.82–416.69), respectively.</p> </sec> <sec id="bjo12443-sec-0008" sec-type="section"> <title>Conclusions</title> <p>Maternal BMI influences maternal and neonatal morbidity, the number and duration of maternal and neonatal admissions, and health service costs.</p> </sec> </abstract>