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Association of maternal obesity and neonatal hypoxic ischemic encephalopathy

Journal of Perinatology volume 40, pages 174–175 (2020)Cite this article

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We found the article “Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia?” by Turner et al. [1] both interesting and informative. Through a retrospective, cohort study the authors showed that infants born to mothers with a BMI ≥ 30 kg/m2 and after cesarean delivery (CD) were more likely to develop neonatal hypoglycemia (NH) and require IV dextrose treatment when compared with the infants whose mothers had a normal BMI and delivered vaginally. The authors also described the timing of NH to be sooner for infants born to obese mothers and those born by CD compared with normal BMI women or infants born vaginally. The earliest onset of NH was for those infants born by cesarean delivery to mothers with BMI ≥ 30.

Researchers have previously established that obesity places the mother-baby dyad at increased risk of CD, macrosomia, and hypoglycemia [2]. Whether maternal obesity is also a risk factor for the development of hypoxic ischemic encephalopathy (HIE) has garnered strong interest. A recent study evaluating the impact of maternal BMI and diabetes status on the risk of asphyxia-related complications to the neonate [3] demonstrated that low Apgar scores and the diagnosis of HIE were increased in infants whose mothers had diabetes and obesity. An increase in HIE, with Apgar scores used as a surrogate for the diagnosis of HIE was noted among infants born to obese or overweight mothers [4] or when comparing urgent and elective cesarean section [5] in women with BMI ≥ 30. The Apgar score alone may not be indicative of HIE nor can it be used exclusively as a surrogate for HIE.

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References

  1. Turner D, Monthe-Dreze C, Cherkerzian S, Gregory K, Sen S. Maternal obesity and cesarean section delivery: additional risk factors for neonatal hypoglycemia? J Perinatol. 2019.

  2. Cnattingius S, Villamor E, Johansson S, Edstedt Bonamy A-K, Persson M, Wilstrom A-K, et al. Maternal obesity and risk of preterm delivery. JAMA. 2013;309:2362–70.

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  5. Smid MC, Vladutiu CJ, Dotters-Katz SK, Manuck TA, Boggess KA, Stamilio DM. Maternal super-obesity and neonatal morbidity after term cesarean delivery. Am J Perinatol. 2016;33:1198–204.

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  1. Albany Medical Center, Albany, NY, USA

    Rubia Khalak & Michael Horgan

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  1. Rubia Khalak
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  2. Michael Horgan
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Correspondence to Rubia Khalak.

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Khalak, R., Horgan, M. Association of maternal obesity and neonatal hypoxic ischemic encephalopathy. J Perinatol 40, 174–175 (2020). https://doi.org/10.1038/s41372-019-0559-7

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