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Geburtshilfe Frauenheilkd 2017; 77(05): 487-494
DOI: 10.1055/s-0043-108763
GebFra Science
Original Article
Georg Thieme Verlag KG Stuttgart · New York

C-Section Prevalence Among Obese Mothers and Neonatal Hypoglycemia: a Cohort Analysis of the Department of Gynecology and Obstetrics of the University of Lübeck

Prävalenz von Sectiones von adipösen Müttern und neonatale Hypoglykämie: eine Kohortenstudie der universitären Frauenklinik Lübeck
Kay Neumann
1   Department of Obstetrics and Gynecology, Schleswig-Holstein University, Campus Lübeck, Lübeck, Germany
,
Ineke Indorf
1   Department of Obstetrics and Gynecology, Schleswig-Holstein University, Campus Lübeck, Lübeck, Germany
,
Christoph Härtel
2   Department of Department of Pediatrics and Child Health, Schleswig-Holstein University, Campus Lübeck, Lübeck, Germany
,
Christoph Cirkel
1   Department of Obstetrics and Gynecology, Schleswig-Holstein University, Campus Lübeck, Lübeck, Germany
,
Achim Rody
1   Department of Obstetrics and Gynecology, Schleswig-Holstein University, Campus Lübeck, Lübeck, Germany
,
Daniel A. Beyer
3   Westpfalz-Klinikum GmbH, Kaiserslautern, Germany
› Author Affiliations
Further Information

Publication History

received 17 February 2017
revised 08 April 2017

accepted 09 April 2017

Publication Date:
24 May 2017 (online)

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Abstract

Introduction Data from the World Health Organization (WHO) demonstrates an increasing prevalence of obesity in Western countries. This study investigates the influence of obesity on the mode of delivery and the occurrence of hypoglycemia in newborns.

Materials and Methods A retrospective analysis of all deliveries at the Department of Gynecology and Obstetrics of the University of Lübeck, Germany was conducted over a period of eleven years with the primary outcome as non-elective C-sections and hypoglycemia of newborns from obese mothers. Patients were divided into six subgroups according to WHO weight classifications as follows: control group body mass index (BMI) 18.5 – 24.9 kg/m2, n = 7712; general obesity BMI ≥ 25 kg/m2, n = 4227; overweight BMI 25 – 29.9 kg/m2, n = 2628; obesity I° BMI 30 – 34.9 kg/m2, n = 1017; obesity II° BMI 35 – 39.9 kg/m2, n = 370; obesity III° BMI ≥ 40 kg/m2, n = 212.

Results Analysis of the primary outcome shows an increased incidence of non-elective C-sections with an elevated BMI (general obesity vs. control group: 20.5 vs. 15.9%, p < 0.001; OR 1.3; 95% CI 1.2 – 1.4) and elevated rates of neonatal hypoglycemia in newborns of obese mothers (general obesity vs. control group: 0.6 vs. 0.3%, p < 0.05; OR 1.8; 95% CI 1.0 – 3.0).

Conclusions Obesity is an essential obstetric risk factor. Obese women face an increased risk of non-elective C-sections, and newborns of obese mothers suffer from elevated rates of hypoglycemia.

Zusammenfassung

Einleitung Nach Daten der Weltgesundheitsorganisation (WHO) steigt die Prävalenz von Adipositas in westlichen Ländern. Die vorliegende Studie untersucht den Einfluss von Adipositas auf den Geburtsmodus sowie auf die Hypoglykämierate der Neugeborenen.

Material und Methoden Retrospektive Kohortenanalyse aller Geburten (n = 17 205) der Universitätsfrauenklinik zu Lübeck im Zeitraum von 11 Jahren. Primäres Zielkriterium: Rate an sekundären Sectiones (= nicht elektiven Sectiones) und Hypoglykämierate von Neugeborenen adipöser Mütter. Einteilung der Patientinnen in 6 verschiedene Subgruppen analog der WHO-Gewichtsklassifikation (Kontrollgruppe BMI 18,5 – 24,9 kg/m2, n = 7712, allgem. Übergewichtige BMI ≥ 25 kg/m2 n = 4227, sowie nach WHO Präadipositas BMI 25 – 29,9 kg/m2 n = 2628, Adipositas I° BMI 30 – 34,9 kg/m2 n = 1017, II° BMI 35 – 39,9 n = 370, III° BMI ≥ 40 n = 212) mit anschließendem Vergleich bezüglich der definierten Outcomeparameter.

Ergebnisse Ein Vergleich der Geburtsmodi zeigt eine steigende Häufigkeit einer sekundären Sectio mit zunehmendem Body-Mass-Index (allgem. Übergewichtige vs. Kontrollgruppe 20,5 vs. 15,9%, p < 0,001; OR 1,3; 95%-KI 1,2 – 1,4). Zudem zeigte sich eine erhöhte Rate an fetalen Hypoglykämien im adipösen Kollektiv (allgem. Übergewichtige vs. Kontrollgruppe 0,6 vs. 0,3%, p < 0,05; OR 1,8; 95%-KI 1,0 – 3,0).

Diskussion Adipositas stellt einen wesentlichen geburtshilflichen und neonatalen Risikofaktor dar. Ein erhöhter mütterlicher BMI senkt die Wahrscheinlichkeit für einen Spontanpartus und das Risiko für kindliche Hypoglykämien nimmt zu.

Key words

adiposity - obesity - mode of delivery - pregnancy - neonatal outcome

Schlüsselwörter

Adipositas - Geburtsmodus - Schwangerschaft - neonatales Outcome
 

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