The association between body mass index (BMI) and severe maternal morbidity (SMM) and/or mortality still remains uncertain. A recent study published in ‘Jama Network Open’ reveals that individuals with prepregnancy obesity had increased risk of severe maternal morbidity and/or mortality from 20 weeks’ gestation through 1 year post partum compared with those with healthy weight.

The study was conducted in 347 497 pregnancies. The primary outcome was a composite of SMM (defined using Centers for Disease Control and Prevention criteria) and/or maternal mortality between 20 weeks’ gestation and 1 year post partum. Additional periods were assessed, including 20 weeks’ gestation through delivery hospitalization and 20 weeks’ gestation through 42 days post partum. Maternal hypertensive diseases and pregestational diabetes were assessed as potential mediators.

According to the researchers, maternal prepregnancy obesity was associated with an elevated risk of SMM and/or mortality. Hypertensive disorders appeared to mediate this association, suggesting that improved prevention and management of hypertensive disorders in pregnancy may reduce morbidity and mortality in individuals with obesity.

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