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The prevalence of super-obesity (body-mass index [BMI] ≥50 kg/m2) has risen markedly in the U.S. To determine whether high maternal BMI confers excess risk for preeclampsia, investigators analyzed Missouri Vital Records data in a population-based retrospective study of >854,000 singleton live births from 1989 to 2005. The study population was stratified into groups based on prepregnancy BMI; weight gain during pregnancy also was evaluated.
In all, 21.4% of births were to obese women (BMI ≥30). Preeclampsia affected 4.5% of pregnancies overall, and rates rose with BMI. Thus, super-obese women (BMI ≥50) had particularly high rates of preeclampsia (13.4%; adjusted odds ratio, 4.7 when compared with normal-weight women [BMI 18.5–24.9]). Incidence of preeclampsia also rose with rate of weight gain during pregnancy: Super-obese women who gained the most weight per week of pregnancy had the highest incidence of preeclampsia (AOR, 13.4 when compared with moderate gain in normal-weight women).
Mbah AK et al. Super-obesity and risk for early and late pre-eclampsia. BJOG 2010 Jul; 117:997.
Comment
These findings are in line with national trends showing that rising obesity rates bring ever more complications associated with pregnancy; moreover, the result shed much-needed light on risks among super-obese women. Emphatic prepregnancy counseling and support regarding weight — as well as ongoing counseling about weight gain during pregnancy (JW Womens Health Jul 2 2009) — are essential.