Pathophysiological and Perioperative Features of Morbidly Obese Parturients

Yigal Leykin; Tommaso Pellis

Disclosures

Expert Rev of Obstet Gynecol. 2009;4(3):313-319. 

In This Article

Epidemiology

The prevalence of obesity is increasing among women in the USA. According to data collected for the National Health and Nutrition Examination Survey, obesity among women 20-39 years of age increased from 26 to 28% between 1999 and 2004.[15] In England (UK), the percentage of women of reproductive age with a BMI greater than 30 increased from 12% in 1993 to 18% in 2002.[16] In Brazil, the prevalence was less; approximately 5.5% of parturients are obese.[17] In nine US states, the prevalence of prepregnancy obesity among women who delivered live infants was 13% in 1993-1994 and 22% in 2002-2003, with a mean increase of 69%, ranging from 45 to 105% according to the individual state.[18] In a study of 14,230 Australian pregnant women, 34% were overweight, obese or morbidly obese.[19,20] Although examining different BMIs, thereby hindering direct comparisons among studies, all epidemiological reports demonstrate a dramatic increase in the prevalence of obesity.

The 2007 Confidential Enquiry into Maternal and Child Health in the UK concluded that 27% of maternal deaths during 2003-2005 were among obese women (BMI > 30), whereas 24% occurred among overweight women (BMI > 25).[21]

Adolescent pregnancy is of significant public-health focus. Overweight adolescent women are at increased risk for adverse neonatal and perinatal outcomes. The WHO reports that approximately 17 million adolescent girls (60 births/1000 girls) give birth each year. In the 1960s and 1970s, the prevalence of overweight girls (12-19 years of age) was 4.7%; this figure increased to 15% according to a survey between 1999 and 2002.[22] These figures set the premises for a further increase in the number of obese parturients in the coming years.

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