Literature DB >> 22930024

Maternal obesity in high-risk pregnancies and postpartum infectious complications.

Letícia Vieira de Paiva1, Roseli Mieko Yamamoto Nomura, Maria Carolina Gonçalves Dias, Marcelo Zugaib.   

Abstract

OBJECTIVE: To analyze the association between maternal obesity and postnatal infectious complications in high-risk pregnancies.
METHODS: Prospective study from August 2009 through August 2010 with the following inclusion criteria: women up to the 5(th) postpartum day; age ≥ 18 years; high-risk pregnancy; singleton pregnancy with live fetus at labor onset; delivery at the institution; maternal weight measured on day of delivery. The nutritional status in late pregnancy was assessed by the body mass index (BMI), with the application of the Atalah et al. curve. Patients were graded as underweight, adequate weight, overweight, or obese. Postpartum complications investigated during the hospital stay and 30 days post-discharge were: surgical wound infection and/or secretion, urinary infection, postpartum infection, fever, hospitalization, antibiotic use, and composite morbidity (at least one of the complications mentioned).
RESULTS: 374 puerperal women were included, graded according to the final BMI as: underweight (n = 54, 14.4%); adequate weight (n = 126, 33.7%); overweight (n = 105, 28.1%); and obese (n = 89, 23.8%). Maternal obesity was shown to have a significant association with the following postpartum complications: surgical wound infection (16.7%, p = 0.042), urinary infection (9.0%, p = 0.004), antibiotic use (12.3%, p < 0.001), and composite morbidity (25.6%, p = 0.016). By applying the logistic regression model, obesity in late pregnancy was found to be an independent variable regardless of the composite morbidity predicted (OR: 2.09; 95% CI: 1.15-3.80, p = 0.015).
CONCLUSION: Maternal obesity during late pregnancy in high-risk patients is independently associated with postpartum infectious complications, which demonstrates the need for a closer follow-up of maternal weight gain in these pregnancies.

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Year:  2012        PMID: 22930024

Source DB:  PubMed          Journal:  Rev Assoc Med Bras (1992)        ISSN: 0104-4230            Impact factor:   1.209


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