AUTHOR=Monaco-Brown Meredith , Munshi Upender , Horgan Michael Joseph , Gifford Jamie L. , Khalak Rubia 

TITLE=Association of Maternal Obesity and Neonatal Hypoxic-Ischemic Encephalopathy

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.850654

DOI=10.3389/fped.2022.850654

ISSN=2296-2360

ABSTRACT=Objective: More women are obese at their first prenatal visit and subsequently gain further weight throughout pregnancy than ever before.  The impact on the infant’s development of hypoxic ischemic encephalopathy (HIE) has not been well studied.  Using defined physiologic and neurologic criteria, our primary aim was to determine if maternal obesity conferred an additional risk of HIE.
Study Design: Data from the New York State Perinatal Data System of all singleton, term births in the Northeastern New York region were reviewed using the NIH obesity definition (Body Mass Index (BMI) ≥ 30 kg/m2).  Neurologic and physiologic parameters were used to diagnose HIE.  Physiologic criteria included the presence of an acute perinatal event, 10-minute Apgar score ≤5, and metabolic acidosis.  Neurologic factors included hypotonia, abnormal reflexes, absent or weak suck, hyperalert or irritable state or evidence of clinical seizures.  Therapeutic hypothermia was initiated if the infant met HIE criteria when assessed by the medical team.  Logistic regression analysis was used to assess the effect of maternal body mass index on the diagnosis of HIE. 
Results: In this large retrospective cohort study we evaluated outcomes of 97,488 pregnancies. Infants born to obese mothers were more likely to require ventilatory assistance and have a lower 5-minute Apgar score. After adjusting for type of delivery and maternal risk factors, infants of obese mothers were diagnosed with HIE more frequently than infants of non-obese mothers, OR 1.96 (1.33-2.89), (p=0.001).
Conclusion: Infants of obese mothers were significantly more likely to have the diagnosis of HIE.