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Maternal overweight and obesity increase the risk of fetal acidosis during labor

Journal of Perinatology volume 38, pages 1144–1150 (2018)Cite this article

Subjects

Abstract

Objective

To investigate whether maternal overweight and obesity increased the risk of fetal acidosis measured in umbilical cord arterial blood after delivery.

Study design

Population-based cohort study of 84,785 term (≥37 weeks) infants. Logistic regression was used to estimate risks of fetal acidosis in umbilical cord arterial blood. Fetal acidosis was defined as pH <7.10 or as pH <1st percentile on a normal reference curve.

Result

Risks of fetal acidosis increased, regardless of definition, with maternal overweight and obesity severity. Compared to normal weight (BMI 18.5–<25), the odds ratios (95% confidence interval) for pH <7.10 were 1.35 (1.23–1.47) for overweight (BMI 25–<30), 1.46 (1.27–1.69) for mild obesity (BMI 30–<35), and 1.75 (1.42–2.15) for severe obesity (BMI ≥35). The association for obesity was attenuated in analyses restricted to non-instrumental vaginal deliveries.

Conclusion

Maternal overweight and obesity increased the risk of fetal acidosis. More complicated deliveries in obese women may partially explain this association.

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Funding

Supported by the Stockholm County Council (ALF No. 20150118) and the Swedish Research Council for Health, Working Life and Welfare (No. 2014-0073). The funders had no involvement in study design, collection, analysis, and/or interpretation of data, writing of the report, or the decision to submit the paper for publication.

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Authors and Affiliations

  1. Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden

    Stefan Johansson, Anna Sandström & Sven Cnattingius

  2. Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden

    Stefan Johansson

Authors
  1. Stefan Johansson
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  2. Anna Sandström
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  3. Sven Cnattingius
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Corresponding author

Correspondence to Stefan Johansson.

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Johansson, S., Sandström, A. & Cnattingius, S. Maternal overweight and obesity increase the risk of fetal acidosis during labor. J Perinatol 38, 1144–1150 (2018). https://doi.org/10.1038/s41372-018-0144-5

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