Abstract
Objectives Despite limited data, antenatal testing has been initiated in many institutions for
women with morbid obesity given their increased risk of stillbirth. Therefore, our
objective was to evaluate the obstetrical implications of antenatal testing in the
morbidly obese population.
Study Design We performed a retrospective cohort study of women undergoing antenatal testing from
January 2011 through December 2012 who delivered at our institution. The exposed group
was women undergoing antenatal testing with morbid obesity (body mass index [BMI]
≥ 40 kg/m2). This group was subdivided into two groups: group 1, which included women undergoing
testing for morbid obesity alone, and group 2, which included women undergoing testing
for morbid obesity with an additional medical comorbidity. The unexposed group (group
3) comprised nonmorbidly obese women (BMI < 35 kg/m2) undergoing antenatal testing for similar medical comorbidities. Our primary outcomes
were induction of labor and gestational age at delivery.
Results A total of 512 women met inclusion criteria. Group 1 had a lower induction rate as
compared with groups 2 and 3 (22.2, 32.5, and 37.6%, respectively; p = 0.003). Additionally, women delivered at a later gestational age in group 1 (39.3
weeks [38.4–40.2]) compared with groups 2 (38.5 weeks [36.1–40.3]) or 3 (37.1 weeks
[37.0–38.2]), p = 0.04. There were no significant differences in our secondary outcomes including
rate of cesarean delivery (p = 0.11) or rate of nonreactive nonstress test (p = 0.4).
Conclusions While it remains unknown whether antenatal testing decreases the stillbirth risk
in morbidly obese women, this population does not appear to be at increased risk of
induction of labor or delivery prior to 39 weeks secondary to testing. Future studies
should evaluate neonatal implications and cost-effectiveness of antenatal testing
in this group.
Keywords
morbid obesity - antenatal testing - nonstress test - induction of labor
