Obesity and Pregnancy

Abstract

Predictive models anticipate that nearly 50% of the population will meet the criteria for obesity by 2030 (Hales CM et al., NCHS Data Brief. 1, 2020; Ward ZJ et al., N Engl J Med. 381:2440–2450, 2019). Women with obesity have increased rates of infertility and early miscarriages. The frequency of >1 miscarriage after spontaneous conception by body mass index (BMI) classification was 16.6% for obese and 11.8% for overweight compared to 10.7% in normal BMI (Boots C, Stephenson MD, Semin Reprod Med. 29:507–13, 2011). Morbidly obese parturient patients have prolonged labor with an increased likelihood of cesarean delivery, increased risk of initial epidural failure, higher fetal birth weights, and increased risk of infection. Obesity presents increased challenges to tocolytic fetal monitoring as well as increased difficulty with hemodynamic monitoring (Taylor CR et al., Local Reg Anesth. 18:111–124, 2019).