The association of pre-pregnancy overweight and obesity with delivery outcomes: a comparison of immigrant and non-immigrant women in Berlin, Germany

Objectives To analyse the influence of maternal overweight/obesity on delivery outcomes among first- and second-generation immigrant women and non-immigrant women. Methods We used perinatal data from Berlin/Germany ( n = 1987 first generation, n = 687 second generation, n = 2185 non-immigrants; g...

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Published in:	International journal of public health 2016-05, Vol.61 (4), p.455-463
Main Authors:	Reiss, Katharina, Breckenkamp, Jürgen, Borde, Theda, Brenne, Silke, Henrich, Wolfgang, David, Matthias, Razum, Oliver
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Berlin Body Mass Index Delivery, Obstetric - methods Emigrants and Immigrants - statistics & numerical data Environmental Health Female Health Behavior - ethnology Humans Labor, Induced Medicine Medicine & Public Health Noncitizens Obesity Obesity - ethnology Occupational Medicine/Industrial Medicine Original Article Overweight - ethnology Pregnancy Pregnancy Complications - ethnology Pregnancy Outcome - ethnology Public Health Risk Factors Socioeconomic Factors Women Young Adult
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Summary:	Objectives To analyse the influence of maternal overweight/obesity on delivery outcomes among first- and second-generation immigrant women and non-immigrant women. Methods We used perinatal data from Berlin/Germany ( n = 1987 first generation, n = 687 second generation, n = 2185 non-immigrants; gestational age: 24+ weeks; maternal age: 18+ years). Poisson models were fitted to estimate the effect of pre-pregnancy overweight/obesity (categorised according to WHO) on mode of delivery (vaginal vs. emergency caesarean section (ECS)) and labour onset (spontaneous vs. induced). Results First generation, second generation and non-immigrant women were more likely to have their labour induced when obese [first generation: RR = 1.41 (95 % CI: 1.15–1.72); second generation: RR = 1.51 (95 % CI: 1.14–2.00); non-immigrants: RR = 1.53 (95 % CI: 1.28–1.81)] compared to normal weight. There were also indications of obese women being more likely to deliver by ECS than women of normal weight, irrespective of migrant status. Conclusions An elevated RR for obese and in parts for overweight women of labour induction and ECS pertains irrespective of migrant status. This warrants further research looking into pathophysiological in addition to health-system factors. Weight control interventions addressed at overweight/obese women planning pregnancies are urgently needed.
ISSN:	1661-8556 1661-8564