Prepregnancy maternal obesity and fetal-perinatal death in a Mediterranean country

Objective: Pre- or early-pregnancy obesity carries significant health implications. This retrospective cohort study investigates the association between pre- or early-pregnancy body mass index (BMI) and the risk of fetal and neonatal death in pregnancies implicated by obesity in a Mediterranean country. Study design: Data on pregnancies delivered during 2003-2008 at a University hospital was linked to data from regional registry. Logistic regression models were used to determine the odds ratios of a spontaneous fetal death and perinatal death among overweight, obese, and morbid obese women. Results: Independent predictors of fetal death were maternal prepregnancy BMI over 25, maternal age, maternal co-morbidities, and maternal residence in an island. Perinatal mortality was independently correlated to neonatal birthweight, maternal age, maternal residence in towns and villages, and maternal BMI over 40. Overall, maternal residence in an island, maternal autoimmune disease, and maternal prepregnancy BMI (over 25) were independent risk factors predicting offspring death (both intrauterine and perinatal). Conclusions: Maternal obesity is correlated to offspring's mortality during fetal and/or perinatal period. This is one of the very few studies in a Mediterranean country. This study underlines the need for public health interventions to prevent obesity in young women.