• R Scott-Pillai, D Spence, C R Cardwell, A Hunter, and V A Holmes.
• School of Nursing and Midwifery, Queen's University, Belfast, UK.
• BJOG. 2013 Jul 1;120(8):932-9.

ObjectiveTo assess the prevalence of overweight and obesity, and the impact of body mass index (BMI) on maternal and neonatal outcomes, in a UK obstetric population.DesignRetrospective study.SettingA tertiary referral unit in Northern Ireland.PopulationA total of 30 298 singleton pregnancies over an 8-year period, 2004-2011.MethodsWomen were categorised according to World Health Organization classification: underweight (BMI < 18.50 kg/m(2)); normal weight (BMI 18.50-24.99 kg/m(2); reference group); overweight (BMI 25.00-29.99 kg/m(2)); obese class I (BMI 30.00-34.99 kg/m(2)); obese class II (BMI 35-39.99 kg/m(2)); and obese class III (BMI ≥ 40 kg/m(2)). Maternal and neonatal outcomes were examined using logistic regression, adjusted for confounding variables.Main Outcome MeasuresMaternal and neonatal outcomes.ResultsCompared with women of normal weight, women who were overweight or obese class I were at significantly increased risk of hypertensive disorders of pregnancy (OR 1.9, 99% CI 1.7-2.3; OR 3.5, 99% CI 2.9-4.2); gestational diabetes mellitus (OR 1.7, 99% CI 1.3-2.3; OR 3.7, 99% CI 2.8-5.0); induction of labour (OR 1.2, 99% CI 1.1-1.3; OR 1.3, 99% CI 1.2-1.5); caesarean section (OR 1.4, 99% CI 1.3-1.5; OR 1.8, 99% CI 1.6-2.0); postpartum haemorrhage (OR 1.4, 99% CI 1.3-1.5; OR 1.8, 1.6-2.0); and macrosomia (OR 1.5, 99% CI 1.3-1.6; OR 1.9, 99% CI 1.6-2.2), with the risks increasing for obese classes II and III. Women in obese class III were at increased risk of preterm delivery (OR 1.6, 99% CI 1.1-2.5), stillbirth (OR 3.0, 99% CI 1.0-9.3), postnatal stay > 5 days (OR 2.1, 99% CI 1.5-3.1), and infant requiring admission to a neonatal unit (OR 1.6, 99% CI 1.0-2.6).ConclusionsBy categorising women into overweight and obesity subclassifications (classes I -III), this study clearly demonstrates an increasing risk of adverse outcomes across BMI categories, with women who are overweight also at significant risk.© 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

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