“The OB-GYN department is justifiably proud of this result, which required a lot of close attention to the mothers’ prenatal care,” said Dr. David McCormick, clinical professor of pediatrics in the Division of General Academic Pediatrics at UTMB. “We were quite surprised by the relatively large proportion of mothers who responded to the educational efforts. We were especially happy to see the benefits on pregnancy-related costs and the favorable infant health outcomes.”
The study, set to be published in the journal Clinical Obesity, compared 82 severely obese pregnant women with 85 healthy weight women. The obese mothers experienced more medical problems during pregnancy, higher medical costs and longer lengths of hospital stay compared to non-obese women. Twenty-six percent of the obese mothers maintained or lost weight during pregnancy and experienced lower medical costs and gave birth to healthier infants.
Neonatal intensive care consumed 78 percent of total hospital costs for infants of the obese women who gained weight, but only 48 percent of costs for infants of obese women who maintained or lost weight.
Total medical charges – including hospital and physician – were 37 percent higher for labor and delivery care for obese mothers and their infant compared to non-obese mothers and their baby.
The findings are important, McCormick said, because 34 percent of reproductive-aged women living in the U.S. are obese. Of these, nearly 19 percent are morbidly obese. The study found that, compared with women whose body mass index was less than 25, women with severe obesity were also more prone to preeclampsia, gestational diabetes, insulin use, cesarean section and prolonged hospitalization.
Compared with infants of normal-weight mothers, infants of obese mothers experienced more complications such as stillbirth, prematurity, excessively large size and neonatal trauma.
Infants of the one-quarter of women with severe obesity who maintained or lost weight during pregnancy were less likely to suffer the adverse consequences of abnormal birth weight. No premature infants or overweight babies were born in this group.
Caregivers in the prenatal clinics advised the mothers on nutrition and exercise, and provided them with written educational materials. Study authors suggest that more research will be needed to fully assess the health risks for infants when an obese woman maintains or loses weight during pregnancy.
Researchers obtained data for the study by reviewing the medical records of 2215 women who delivered at UTMB from June through December 2009.
This study was written by Dr. Maria Caldas, Dr. Justin Serrette, Dr. Sunil Jain, and Dr. David McCormick of UTMB’s Department of Pediatrics, and Michel Makhlouf and Gayle Olson of the Department of Obstetrics and Gynecology. The study, “Maternal obesity: financial implications of weight management” has been published in the journal, Clinical Obesity. Clinical Obesity can be accessed at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1758-8111.
The University of Texas Medical Branch at Galveston