by Will Boggs, MD

Last Updated: 2007-11-16 14:12:47 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Maternal obesity increases the risk of neonatal mortality, especially in infants born after preterm premature rupture of membranes (PROM), according to a report in the November issue of Obstetrics & Gynecology.

"The findings may indicate a potential problem in the management of preterm PROM births in obese women," Dr. Ellen Aagaard Nohr from University of Aarhus, Denmark told Reuters Health. "Preterm infants of obese mothers may be more susceptible when they are not protected by the membranes."

Dr. Nohr and colleagues used the Danish National Birth Cohort to investigate the association between prepregnancy obesity and neonatal mortality, with focus upon different subtypes of preterm birth.

The crude neonatal mortality rate was higher in infants of overweight and obese mothers than in infants of normal-weight mothers, the authors report, even after adjustment for maternal and neonatal risk factors.

Neonatal mortality in infants born after preterm PROM was more than tripled in infants of overweight women and was increased nearly six-fold in infants of obese women, the report indicates.

High body mass index was not, however, associated with neonatal mortality in infants born after spontaneous preterm birth without preterm PROM.

The results were similar in infants with or without malformations and after exclusion of infants born to women with obesity-related diseases or infants born to subfertile women, the researchers note.

"This is the first study indicating an elevated mortality in infants of obese mothers after preterm PROM, and it is therefore too early to suggest changes in the management of pregnancies in obese women," Dr. Nohr said.

"However, if these findings are causal and we understand the mechanisms behind them, it may be possible to suggest preventive measures," she added.

Obstet Gynecol 2007;110:1083-1090.