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Maternal overweight and obesity increase the risk of fetal acidosis during labor.

OBJECTIVE: To investigate whether maternal overweight and obesity increased the risk of fetal acidosis measured in umbilical cord arterial blood after delivery.

STUDY DESIGN: Population-based cohort study of 84,785 term (≥37 weeks) infants. Logistic regression was used to estimate risks of fetal acidosis in umbilical cord arterial blood. Fetal acidosis was defined as pH <7.10 or as pH <1st percentile on a normal reference curve.

RESULT: Risks of fetal acidosis increased, regardless of definition, with maternal overweight and obesity severity. Compared to normal weight (BMI 18.5-<25), the odds ratios (95% confidence interval) for pH <7.10 were 1.35 (1.23-1.47) for overweight (BMI 25-<30), 1.46 (1.27-1.69) for mild obesity (BMI 30-<35), and 1.75 (1.42-2.15) for severe obesity (BMI ≥35). The association for obesity was attenuated in analyses restricted to non-instrumental vaginal deliveries.

CONCLUSION: Maternal overweight and obesity increased the risk of fetal acidosis. More complicated deliveries in obese women may partially explain this association.

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