The United States is witnessing an obesity epidemic. The maternal body mass index (BMI) and weight gain during pregnancy influence fetal growth. Little is known about fetal growth patterns (FGP) on obese women. The present study was performed to characterize FGPs among obese pregnant women (BMI>30) in a Maternal Fetal Medicine (MFM) practice.METHODS:
Retrospective review of the ultrasound database of a private MFM practice in Houston. 43 obese patients with 3 or more ultrasounds and with completed pregnancies were included. Demographic, biometric and clinical data were obtained for mothers and neonates. Fetal growth was classified as normal, accelerated or decelerated. Chi square and Student-t test were performed as appropriate. Significance P<.05.RESULTS:
The average patient was 33 yo (± 4.6) and had a BMI of 36.1 (± 6.3). The fetal growth was accelerated in 51.1%, normal in 46.5% and decelerated in 2.3%. The proportion of fetuses with an AC >95th p/GA increased from 18% at 32 weeks to 38% at 36 weeks. A significant difference (P<.0001) was observed in birth-weight between patients who had EFW accelerations and patients who didn’t (3.52 kg ± 0.47 vs 2.93 kg ± 0.62). An improvement of the fetal growth pattern (in EFW and/or AC) was observed in 31.8% of accelerated growth as a result of interventions (diet and activity) recommended to the mothers.CONCLUSION:
Fetal growth is accelerated in over half of obese women followed with serial ultrasounds. The modification of FGP's suggests that an accelerated fetal growth might be responsive to medical interventions.