Impact of maternal overweight and obesity on perinatal outcomes

Maternal obesity adversely affects perinatal outcome through increasing rates of hypertensive disease during pregnancy, diabetes, cesarean section and fetal macrosomia. To investigate the prevalence of prepregnancy over weight and obesity and their impact on pregnancy and perinatal outcomes in Jordan. A prospective study comparing prepregnancy BMI categories with pregnancy and perinatal outcomes. University teaching hospital. Singleton term babies [>37 weeks] born in the year 2009. A total of 2129 newborns were categorized according to their mothers self reported body mass index [BMI] into three groups [normal, over weight and obese]. Multivariate regression analysis was performed. The main outcomes were pregnancy induced hypertension, gestational diabetes, mode of delivery, birthweight, neonatal admission and death. A total 2129 newborns were identified. The incidence of overweight and obese mothers was 33.6% and 12.5%, respectively. In comparison to mothers with normal BMI, overweight and obese mothers were older and more likely to be multiparious. Their pregnancy was at a significantly higher risk for pregnancy-induced hypertension, gestational diabetes, Cesarean delivery, induction of labor, giving birth to a macrocosmic baby and neonatal admission. Obese women were less likely to have instrumental delivery. Babies born to overweight and obese mothers were not at a higher risk of having other short adverse perinatal outcomes. Increasing prepregnancy BMI was associated with increased risk of adverse outcomes. Effective Interventional programs are important implications for health policy for counseling mothers during antenatal, postnatal and primary health care visit

Effects of perinatal risk factors on common neonatal respiratory morbidities beyond 36 weeks of gestation

To assess the incidence of respiratory morbidity [RM] in all single live neonates born >36 weeks of gestation, and the effects of perinatal characteristics on these morbidities. This is a prospective hospital based study covering a 12-month period. The study took place at the Department of Pediatrics, Jordan University Hospital, Amman, Jordan, between January and December 2009. The effects of different perinatal characteristics on RM including transient tachypnea of the newborn [TTN] and respiratory distress syndrome [RDS] were analyzed. A total of 2282 newborns were included. One thousand two hundred and seventy-six [55.9%] of the newborns were delivered by vaginal delivery and 1,006 [44%] by cesarean section [CS] [24.5% by emergency CS and 19.5% by elective CS]. Respiratory morbidity was reported in 3.7%. The incidence of TTN was 2.9% and RDS was 0.7%. Elective CS was found to be a risk factor for RM development when the gestational age was <39 weeks. Maternal hypertension and diabetes mellitus, and the absence of labor were independent risk factors for RM. The emergency CS and large for gestational age babies were risk factors for TTN, while male gender and GA <37[o+6] weeks were risk factor for RDS. The collaborative obstetric and neonatology responsibility helps to identify the risk factors for adverse respiratory outcome when considering the time and mode of delivery. The pregnant mother should be informed regarding this possibility if delivery by elective CS is performed before the 39[o+6] weeks of gestation