HEALTH OF WOMAN. 2019.2(138): 104–121

Green-top Guideline No. 72 November 2018
https://www.rcog.org.uk/en/guidelines-research-services/guidelines
Abridged version. Adapted – S.A. Shurpyak

REFERENCES

1. NMPA Project Team. National Maternal and Perinatal Audit: Clinical Report 2017. London: RCOG. 2017.

2. World Health Organization. Obesity: preventing and managing theglobal epidemic. WHO Technical Report Series. Geneva, WHO. 2000.

3. Heslehurst N, Lang R, Rankin J, Wilkinson JR, Summerbell CD. 2007. Obesity in pregnancy: a study of the impact of maternal obesity on NHS maternity services. BJOG 114:334–42.

4. Kanagalingam MG, Forouhi NG, Greer IA, Sattar N. 2005. Changes in booking body mass index over a decade: retrospective analysis from a Glasgow Maternity Hospital. BJOG 112:1431–3.

5. Aune D, Saugstad OD, Henriksen T, Tonstad S. 2014. Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis. JAMA 311:1536–46.

6. Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S. 2007. Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 7:168.

7. Brite J, Laughon SK, Troendle J, Mills J. 2014. Maternal overweight and obesity and risk of congenital heart defects in offspring. Int J Obes (Lond) 38:878–82.

8. Callaway LK, Prins JB, Chang AM, McIntyre HD. 2006. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust 184:56–9.

9. Cedergren MI. 2004. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 103:219–24.

10. Denison FC, Norrie G, Graham B, Lynch J, Harper N, Reynolds RM. 2009. Increased maternal BMI is associated with an increased risk of minor complications during pregnancy with consequent cost implications. BJOG 116:1467–72.

11. Denison FC, Norwood P, Bhattacharya S, Duffy A, Mahmood T, Morris C et al. 2014. Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study. BJOG 121:72–81, discussion 82.

12. Denison FC, Price J, Graham C, Wild S, Liston WA. 2008. Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labour at term. BJOG 115:720–5.

13. Gaillard R, Steegers EA, Hofman A, Jaddoe VW. 2011. Associations of maternal obesity with blood pressure and the risks of gestational hypertensive disorders. The Generation R Study. J Hypertens 29:937–44.

14. Hollowell J, Pillas D, Rowe R, Linsell L, Knight M, Brocklehurst P. 2014. The impact of maternal obesity on intrapartum outcomes in otherwise low risk women: secondary analysis of the Birthplace national prospective cohort study. BJOG 121:343–55.

15. Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW et al. 2001. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 25:1175–82.

16. Weiss JL, Malone FD, Emig D, Ball RH, Nyberg DA, Comstock CH et al. 2004. FASTER Research Consortium. Obesity, obstetric complica- tions and cesarean delivery rate–a population-based screening study. Am J Obstet Gynecol 190:1091–7.

17. Zhou A, Xiong C, Hu R, Zhang Y, Bassig BA, Triche E et al. 2015. Pre-pregnancy BMI, gestational weight gain, and the risk of hypertensive disorders of pregnancy: a cohort study in Wuhan, China. PLoS One 10:e0136291.

18. Lisonkova S, Muraca GM, Potts J, Liauw J, Chan WS, Skoll A et al. 2017. Association Between Prepregnancy Body Mass Index and Severe Maternal Morbidity. JAMA 318:1777–86.

19. Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ, editors, on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care – Lessons Learned to Inform Future Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-12. Oxford: National Perinatal Epidemiology Unit, University of Oxford. 2014.

20. Lashen H, Fear K, Sturdee DW. 2004. Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case-control study. Hum Reprod 19:1644–6.

21. O’Brien TE, Ray JG, Chan WS. 2003. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology 14:368–74.

22. Jacobsen AF, Skjeldestad FE, Sandset PM. 2008. Ante- and postnatal risk factors of venous thrombosis: a hospital-based case-control study. J Thromb Haemost 6:905–12.

23. Larsen TB, Sшrensen HT, Gislum M, Johnsen SP. 2007. Maternal smoking, obesity, and risk of venous thromboembolism during pregnancy and the puerperium: a population-based nested case- control study. Thromb Res 120:505–9.

24. Usha Kiran TS, Hemmadi S, Bethel J, Evans J. 2005. Outcome of pregnancy in a woman with an increased body mass index. BJOG 112:768–72.

25. Carlson NS, Hernandez TL, Hurt KJ. 2015. Parturition dysfunction in obesity: time to target the pathobiology. Reprod Biol Endocrinol 13:135.

26. Chu SY, Kim SY, Schmid CH, Dietz PM, Callaghan WM, Lau J et al. 2007. Maternal obesity and risk of cesarean delivery: a meta- analysis. Obes Rev 8:385–94.

27. Beckett VA, Knight M, Sharpe P. 2017. The CAPS Study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study. BJOG 124:1374–81.

28. Juvin P, Lavaut E, Dupont H, Lefevre P, Demetriou M, Dumoulin JL et al. 2003. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg 97:595–600, table of contents.

29. Lundstrшm LH, Mшller AM, Rosenstock C, Astrup G, Wetterslev J. 2009. High body mass index is a weak predictor for difficult and failed tracheal intubation: a cohort study of 91,332 consecutive patients scheduled for direct laryngoscopy registered in the Danish Anesthesia Database. Anesthesiology 110:266–74.

30. Members of the Working Party, Nightingale CE, Margarson MP, Shearer E, Redman JW, Lucas DN et al. 2015. Association of the Anaesthetists of Great Britain. Ireland Society for Obesity and Bariatric Anaesthesia. Peri-operative management of the obese surgical patient 2015: Association of Anaesthetists of Great Britain and Ireland Society for Obesity and Bariatric Anaesthesia. Anaesthesia 70:859–76.

31. Tonidandel A, Booth J, D’Angelo R, Harris L, Tonidandel S. 2014. Anesthetic and obstetric outcomes in morbidly obese parturients: a 20-year follow-up retrospective cohort study. Int J Obstet Anesth 23:357–64.

32. Fyfe EM, Thompson JMD, Anderson NH, Groom KM, McCowan LM. 2012. Maternal obesity and postpartum haemorrhage after vaginal and caesarean delivery among nulliparous women at term: a retrospective cohort study. BMC Pregnancy Childbirth 12:112.

33. Dinatale A, Ermito S, Fonti I, Giordano R, Cacciatore A, Romano M et al. 2010. Obesity and fetal-maternal outcomes. J Prenat Med 4:5–8.

34. Amir LH, Donath S. 2007. A systematic review of maternal obesity and breastfeeding intention, initiation and duration. BMC Pregnancy Childbirth 7:9.

35. Rasmussen SA, Chu SY, Kim SY, Schmid CH, Lau J. 2008. Maternal obesity and risk of neural tube defects: a metaanalysis. Am J Obstet Gynecol 198:611–9.

36. Kristensen J, Vestergaard M, Wisborg K, Kesmodel U, Secher NJ. 2005. Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG 112:403–8.

37. Norman JE, Reynolds RM. 2011. The consequences of obesity and excess weight gain in pregnancy. Proc Nutr Soc 70:450–6.

38. National Institute of Health and Care Excellence. Obesity: identification, assessment and management. Clinical guideline 189. London, NICE. 2014.

39. Knight-Agarwal CR, Williams LT, Davis D, Davey R, Cochrane T, Zhang H et al. 2016. Association of BMI and interpregnancy BMI change with birth outcomes in an Australian obstetric population: a retrospective cohort study. BMJ Open 6:e010667.

40. McBain RD, Dekker GA, Clifton VL, Mol BW, Grzeskowiak LE. Impact of inter-pregnancy BMI change on perinatal outcomes: a retrospective cohort study. Eur J Obstet Gynecol Reprod Biol 2016;205:98–104.

41. Salihu HM. Maternal obesity and stillbirth. Semin Perinatol 35:340–4. 2011.

42. Whiteman VE, Crisan L, McIntosh C, Alio AP, Duan J, Marty PJ et al. 2011. Interpregnancy body mass index changes and risk of stillbirth. Gynecol Obstet Invest 72:192–5.

43. Callegari LS, Sterling LA, Zelek ST, Hawes SE, Reed SD. 2014. Interpregnancy body mass index change and success of term vaginal birth after cesarean delivery. Am J Obstet Gynecol 210:330.e1–7.

44. De-Regil LM, Pe~na-Rosas JP, Fern andez-Gaxiola AC, Rayco-Solon P. 2015. Effects and safety of periconceptional oral folate supplementation for preventing birth defects. Cochrane Database Syst Rev (12): CD007950.

45. Mojtabai R. 2004. Body mass index and serum folate in childbearing age women. Eur J Epidemiol 19:1029–36.

46. Zetstra-van der Woude PA, De Walle HE, Hoek A, Bos HJ, Boezen HM, Koppelman GH et al. 2014. Maternal high-dose folic acid during pregnancy and asthma medication in the offspring. Pharmacoepidemiol Drug Saf 23:1059–65.

47. Wang T, Zhang HP, Zhang X, Liang ZA, Ji YL, Wang G. 2015. Is folate status a risk factor for asthma or other allergic diseases? Allergy Asthma Immunol Res 7:538–46.

48. Moussa HN, Hosseini Nasab S, Haidar ZA, Blackwell SC, Sibai BM. 2016. Folic acid supplementation: what is new? Fetal, obstetric, long- term benefits and risks. Future Sci OA 2:FSO116.

49. Stern SJ, Matok I, Kapur B, Koren G. 2012. Dosage requirements for periconceptional folic acid supplementation: accounting for BMI and lean body weight. J Obstet Gynaecol Can 34:374–8.

50. Bodnar LM, Catov JM, Roberts JM, Simhan HN. 2007. Prepregnancy obesity predicts poor vitamin D status in mothers and their neonates. J Nutr 137:2437–42.

51. Office for National Statistics. National Diet and Nutrition Survey 4. Nutritional Status (Anthropometry and Blood Analytes), Blood Pressure and Physical Activity. London, ONS. 2004.

52. De-Regil LM, Palacios C, Lombardo LK, Pe~na-Rosas JP. 2016. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev (1):CD008873.

53. Cooper C, Harvey NC, Bishop NJ, Kennedy S, Papageorghiou AT, Schoenmakers I et al. 2016. Maternal gestational vitamin D supplementa- tion and offspring bone health (MAVIDOS): a multicentre, double- blind, randomised placebo-controlled trial. Lancet Diabetes Endocrinol 4:393–402.

54. NHS Litigation Authority. Clinical Negligence Scheme for Trusts: Maternity Clinical Risk Management Standards. Version 1. London: NHS Litigation Authority. 2013.

55. Royal College of Obstetricians and Gynaecologists. Management of Women with Obesity in Pregnancy. London: RCOG/CMACE. 2010.

56. Health and Safety Executive. RR573 – Risk assessment and process planning for bariatric patient handling pathways. Merseyside, HSE. 2007.

57. The Association of Anaesthetists of Great Britain and Ireland. Peri-operative management of the morbidly obese patient. London, AAGBI. 2007.

58. National Institute for Health and Care Excellence. Antenatal care for uncomplicated pregnancies. Clinical guideline 62. Manchester, NICE. 2017.

59. Headen I, Cohen AK, Mujahid M, Abrams B. 2017. The accuracy of self-reported pregnancy-related weight: a systematic review. Obes Rev 18:350–69.

60. Scott C, Andersen CT, Valdez N, Mardones F, Nohr EA, Poston L et al. 2014. No global consensus: a cross-sectional survey of maternal weight policies. BMC Pregnancy Childbirth 14:167.

61. Yaktine AL, Rasmussen KM, editors. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington DC, National Academies Press. 2009.

62. Koletzko B, Bauer CP, Bung P, Cremer M, FlothkoЂtter M, Hellmers C et al. 2013. German national consensus recommendations on nutrition and lifestyle in pregnancy by the ‘Healthy Start – Young Family Network’. Ann Nutr Metab 63:311–22.

63. National Institute for Health and Care Excellence. Weight management before, during and after pregnancy. Public health guideline 27. Manchester, NICE. 2010.

64. Faucher MA, Barger MK. 2015. Gestational weight gain in obese women by class of obesity and select maternal/newborn outcomes: a systematic review. Women Birth 28:e70–9.

65. Moos MK, Dunlop AL, Jack BW, Nelson L, Coonrod DV, Long R et al. 2008. Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age. Am J Obstet Gynecol 199;2:S280–9.

66. Association of Anaesthetists of Great Britain and Ireland and Obstetric Anaesthetists’ Association. OAA/AAGBI Guidelines for Obstetrics Anaesthetic Services 2013. London, OAA/AAGBI. 2013.

67. Keely A, Cunningham-Burley S, Elliott L, Sandall J, Whittaker A. 2017. If she wants to eat … and eat and eat … fine! It’s gonna feed the baby: pregnant women and partners’ perceptions and experiences of pregnancy with a BMI >40 kg/m². Midwifery 49:87–94.

68. Kallen BA. 2014. Antiobesity drugs in early pregnancy and congenital malformations in the offspring. Obes Res Clin Pract 8:e571–6.

69. Alsaad AM, Chaudhry SA, Koren G. 2015. First trimester exposure to topiramate and the risk of oral clefts in the offspring: a systematic review and meta-analysis. Reprod Toxicol 53:45–50.

70. Wong D, Sullivan K, Heap G. 2012. The pharmaceutical market for obesity therapies. Nat Rev Drug Discov 11:669–70.

71. Fantasia HC. 2013. New developments in the pharmacologic treatment of obesity. Nurs Womens Health 17:53–62.

72. U.S. Food & Drug Administration. Belviq. Silver Spring, Maryland, USA: FDA. 2012. https://www.accessdata.fda.gov/drugsatfda_doc 
s/label/2012/022529lbl.pdf. Accessed 2018 Aug 1.

73. Kheterpal S, Han R, Tremper KK, Shanks A, Tait AR, O’Reilly M et al. 2006. Incidence and predictors of difficult and impossible mask ventilation. Anesthesiology 105:885–91.

74. Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A et al. 2015. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth 115:827–48.

75. Mushambi MC, Kinsella SM, Popat M, Swales H, Ramaswamy KK, Winton AL. Quinn AC; Obstetric Anaesthetists’ Association; Difficult Airway Society. 2015. Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia 70:1286–306.

76. Roberts RB, Shirley MA. 1974. Reducing the risk of acid aspiration during cesarean section. Anesth Analg 53:859–68.

77. Drake DJ, Swanson M, Baker G, Pokorny M, Rose MA, Clark-Reed L et al. 2010. The association of BMI and Braden total score on the occurrence of pressure ulcers. J Wound Ostomy Continence Nurs 37:367–71.

78. VanGilder C, MacFarlane G, Meyer S, Lachenbruch C. 2009. Body mass index, weight, and pressure ulcer prevalence: an analysis of the 2006-2007 International Pressure Ulcer Prevalence Surveys. J Nurs Care Qual 24:127–35.

79. Lindgren M, Unosson M, Fredrikson M, Ek AC. 2004. Immobility–a major risk factor for development of pressure ulcers among adult hospitalized patients: a prospective study. Scand J Caring Sci 18:57–64.

80. National Institute for Health and Care Excellence. Pressure ulcers: prevention and management. clinical guideline 179. Manchester, NICE. 2014.

81. National Institute for Health and Care Excellence. Diabetes in pregnancy: management from preconception to the postnatal period. NICE Guideline 3. Manchester, NICE. 2015.

82. Scottish Intercollegiate Guidelines Network. Management of diabetes: a national clinical guideline. Number 116. Edinburgh, SIGN. 2010.

83. Bianco AT, Smilen SW, Davis Y, Lopez S, Lapinski R, Lockwood CJ. 1998. Pregnancy outcome and weight gain recommendations for the morbidly obese woman. Obstet Gynecol 91:97–102.

84. Moore LL, Singer MR, Bradlee ML, Rothman KJ, Milunsky A. 2000. A prospective study of the risk of congenital defects associated with maternal obesity and diabetes mellitus. Epidemiology 11:689–94.

85. Catalano PM, McIntyre HD, Cruickshank JK, McCance DR, Dyer AR, Metzger BE et al. 2012. HAPO Study Cooperative Research Group. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care 35:780–6.

86. Maxwell MH, Waks AU, Schroth PC, Karam M, Dornfeld LP. 1982. Error in blood-pressure measurement due to incorrect cuff size in obese patients. Lancet 2:33–6.

87. Wang Z, Wang P, Liu H, He X, Zhang J, Yan H et al. 2013. Maternal adiposity as an independent risk factor for pre-eclampsia: a meta- analysis of prospective cohort studies. Obes Rev 14:508–21.

88. National Institute of Health and Care Excellence. Hypertension in pregnancy: diagnosis and management. Clinical guidelines 107. Manchester, NICE. 2011.

89. Schumann NL, Brinsden H, Lobstein T. 2014. A review of national health policies and professional guidelines on maternal obesity and weight gain in pregnancy. Clin Obes 4:197–208.

90. Rolnik DL, Wright D, Poon LC, O’Gorman N, Syngelaki A, de Paco MC et al. 2017. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. N Engl J Med 377: 613–22.

91. Roberge S, Nicolaides K, Demers S, Hyett J, Chaillet N, Bujold E. 2017. The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis. Am J Obstet Gynecol 216:110–20.

92. Ayala DE, Ucieda R, Hermida RC. 2013. Chronotherapy with low-dose aspirin for prevention of complications in pregnancy. Chronobiol Int 30:260–79.

93. Chen Q, Wei J, Tong M, Yu L, Lee AC, Gao YF et al. 2015. Associations between body mass index and maternal weight gain on the delivery of LGA infants in Chinese women with gestational diabetes mellitus. J Diabetes Complications 29:1037–41.

94. James AH, Jamison MG, Brancazio LR, Myers ER. 2006. Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol 194:1311–5.

95. Kane EV, Calderwood C, Dobbie R, Morris C, Roman E, Greer IA. 2013. A population-based study of venous thrombosis in pregnancy in Scotland 1980-2005. Eur J Obstet Gynecol Reprod Biol 169:223–9.

96. Knight M, UKOSS. 2008. Antenatal pulmonary embolism: risk factors, management and outcomes. BJOG 115:453–61.

97. Simpson EL, Lawrenson RA, Nightingale AL, Farmer RD. 2001. Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database. BJOG 108:56–60.

98. Royal College of Obstetricians and Gynaecologists. Reducing the Risk of Venous Thromboembolism during Pregnancy and the Puerperium. Green-top Guideline No. 37a. London, RCOG. 2015.

99. Royal College of Obstetricians and Gynaecologists. Reducing the Risk of Venous Thromboembolic Disease in Pregnancy and the Puerperium: Acute Management. Green-top Guideline 37b. London, RCOG. 2015.

100. Ismail SK, Norris L, O’Shea S, Higgins JR. 2014. Weight-adjusted LMWH prophylaxis provides more effective thrombin inhibition in morbidly obese pregnant women. Thromb Res 134:234–9. 


101. Overcash RT, Somers AT, LaCoursiere DY. 2015. Enoxaparin dosing after cesarean delivery in morbidly obese women. Obstet Gynecol 125:1371–6.

102. Molyneaux E, Poston L, Ashurst-Williams S, Howard LM. 2014. Obesity and mental disorders during pregnancy and postpartum: a systematic review and meta-analysis. Obstet Gynecol 123:857–67.

103. Ban L, Gibson JE, West J, Fiaschi L, Oates MR, Tata LJ. 2012. Impact of socioeconomic deprivation on maternal perinatal mental illnesses presenting to UK general practice. Br J Gen Pract 62:e671–8.

104. Micali N, Simonoff E, Treasure J. 2011. Pregnancy and post-partum depression and anxiety in a longitudinal general population cohort: the effect of eating disorders and past depression. J Affect Disord 131:150–7.

105. Rallis S, Skouteris H, Wertheim EH, Paxton SJ. 2007. Predictors of body image during the first year postpartum: a prospective study. Women Health 45:87–104.

106. Easter A, Bye A, Taborelli E, Corfield F, Schmidt U, Treasure J et al. 2013. Recognising the symptoms: how common are eating disorders in pregnancy? Eur Eat Disord Rev 21:340–4.

107. Bulik CM, Von Holle A, Hamer R, Knoph Berg C, Torgersen L, Magnus P et al. 2007. Patterns of remission, continuation and incidence of broadly defined eating disorders during early pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Psychol Med 37:1109–18.

108. Bod en R, Lundgren M, Brandt L, Reutfors J, Kieler H. 2012. Antipsychotics during pregnancy: relation to fetal and maternal metabolic effects. Arch Gen Psychiatry 69:715–21.

109. Bogaerts AF, Devlieger R, Nuyts E, Witters I, Gyselaers W, Guelinckx I et al. 2013. Anxiety and depressed mood in obese pregnant women: a prospective controlled cohort study. Obes Facts 6:152–64.

110. Claesson IM, SydsjoЂ G, Brynhildsen J, Cedergren M, Jeppsson A, Nystro€m F et al. 2008. Weight gain restriction for obese pregnant women: a case-control intervention study. BJOG 115:44–50.

111. Dodd JM, Crowther CA, Robinson JS. 2008. Dietary and lifestyle interventions to limit weight gain during pregnancy for obese or overweight women: a systematic review. Acta Obstet Gynecol Scand 87:702–6.

112. National Institute of Health and Care Excellence. Antenatal and postnatal mental health: clinical management and service guidance. Clinical guideline 192. Manchester; NICE. 2014.

113. Stothard KJ, Tennant PW, Bell R, Rankin J. 2009. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA 301:636–50.

114. Aagaard-Tillery KM, Flint Porter T, Malone FD, Nyberg DA, Collins J, Comstock CH et al. 2010. Influence of maternal BMI on genetic sonography in the FaSTER trial. Prenat Diagn 30:14–22.

115. Gandhi M, Fox NS, Russo-Stieglitz K, Hanley ME, Matthews G, Rebarber A. 2009. Effect of increased body mass index on first- trimester ultrasound examination for aneuploidy risk assessment. Obstet Gynecol 114:856–9.

116. Thornburg LL, Mulconry M, Post A, Carpenter A, Grace D, Pressman EK. 2009. Fetal nuchal translucency thickness evaluation in the overweight and obese gravida. Ultrasound Obstet Gynecol 33:665–9.

117. Tsai LJ, Ho M, Pressman EK, Thornburg LL. 2010. Ultrasound screening for fetal aneuploidy using soft markers in the overweight and obese gravida. Prenat Diagn 30:821–6.

118. Canick JA, Palomaki GE, Kloza EM, Lambert-Messerlian GM, Haddow JE. 2013. The impact of maternal plasma DNA fetal fraction on next generation sequencing tests for common fetal aneuploidies. Prenat Diagn 33:667–74.

119. Ashoor G, Syngelaki A, Poon LC, Rezende JC, Nicolaides KH. 2013. Fetal fraction in maternal plasma cell-free DNA at 11-13 weeks’ gestation: relation to maternal and fetal characteristics. Ultrasound Obstet Gynecol 41:26–32.

120. Harper LM, Cahill AG, Smith K, Macones GA, Odibo AO. 2012. Effect of maternal obesity on the risk of fetal loss after amniocentesis and chorionic villus sampling. Obstet Gynecol 119:745–51.

121. Phatak M, Ramsay J. 2010. Impact of maternal obesity on procedure of mid-trimester anomaly scan. J Obstet Gynaecol 30:447–50.

122. Chung JH, Pelayo R, Hatfield TJ, Speir VJ, Wu J, Caughey AB. 2012. Limitations of the fetal anatomic survey via ultrasound in the obese obstetrical population. J Matern Fetal Neonatal Med 25:1945–9.

123. Hendler I, Blackwell SC, Bujold E, Treadwell MC, Mittal P, Sokol RJ et al. 2005. Suboptimal second-trimester ultrasonographic visualization of the fetal heart in obese women: should we repeat the examination? J Ultrasound Med 24:1205–9; quiz 1210–1.

124. Royal College of Obstetricians and Gynaecologists. The Investigation and Management of the Small–for–Gestational–Age Fetus. Green-top Guideline 31. London, RCOG. 2014.

125. Bailey SM, Sarmandal P, Grant JM. 1989. A comparison of three methods of assessing inter-observer variation applied to measurement of the symphysis-fundal height. Br J Obstet Gynaecol 96:1266–71.

126. Morse K, Williams A, Gardosi J. 2009. Fetal growth screening by fundal height measurement. Best Pract Res Clin Obstet Gynaecol 23:809–18.

127. National Institute of Health and Care Excellence. Intrapartum care for healthy women and babies. Clinical guideline CG190. Manchester, NICE. 2017.

128. Smith GC. 2001. Life-table analysis of the risk of perinatal death at term and post term in singleton pregnancies. Am J Obstet Gynecol 184:489–96.

129. Arrowsmith S, Wray S, Quenby S. 2011. Maternal obesity and labour complications following induction of labour in prolonged pregnancy. BJOG 118:578–88.

130 American College of Obstetricians and Gynecologists. 2014. Practice bulletin 146: management of late-term and postterm pregnancies. Obstet Gynecol 124:390–6.

131. Birthplace in England Collaborative Group, Brocklehurst P, Hardy P, Hollowell J, Linsell L, Macfarlane A, McCourt C et al. 2011. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ 343:d7400.

132. Mavrides E, Allard S, Chandraharan E, Collins P, Green L, Hunt BJ et al. 2016. Prevention and management of postpartum haemorrhage. BJOG 124:e106–49.

133. Lee VR, Darney BG, Snowden JM, Main EK, Gilbert W, Chung J et al. 2016. Term elective induction of labour and perinatal outcomes in obese women: retrospective cohort study. BJOG 123:271–8.

134. Gaudet L, Ferraro ZM, Wen SW, Walker M. 2014. Maternal obesity and occurrence of fetal macrosomia: a systematic review and meta-analysis. Biomed Res Int 2014:640291.

135. Boulvain M, Irion O, Dowswell T, Thornton JG. 2016. Induction of labour at or near term for suspected fetal macrosomia. Cochrane Database Syst Rev (5):CD000938.

136. Poobalan AS, Aucott LS, Gurung T, Smith WC, Bhattacharya S. 2009. Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women–systematic review and meta-analysis of cohort studies. Obes Rev 10:28–35.

137. Wolfe H, Timofeev J, Tefera E, Desale S, Driggers RW. 2014. Risk of cesarean in obese nulliparous women with unfavorable cervix: elective induction vs expectant management at term. Am J Obstet Gynecol 211:e1–5.

138. Subramaniam A, Jauk VC, Goss AR, Alvarez MD, Reese C, Edwards RK. 2014. Mode of delivery in women with class III obesity: planned cesarean compared with induction of labor. Am J Obstet Gynecol 211:700.e1–700.e9.

139. Boulvain M, Senat MV, Perrotin F, Winer N, Beucher G, Subtil D et al. 2015. Groupe de Recherche en Obst etrique et Gyn ecologie (GROG). Induction of labour versus expectant management for large-for-date fetuses: a randomised controlled trial. Lancet 385:2600–5.

140. Magro-Malosso ER, Saccone G, Chen M, Navathe R, Di Tommaso M, Berghella V. 2017. Induction of labour for suspected macrosomia at term in non-diabetic women: a systematic review and meta-analysis of randomized controlled trials. BJOG 124:414–21.

141. Royal College of Obstetricians and Gynaecologists. Birth after Previous Caesarean Birth. Green-top Guideline. 45. London, RCOG. 2015.

142. Durnwald CP, Ehrenberg HM, Mercer BM. 2004. The impact of maternal obesity and weight gain on vaginal birth after cesarean section success. Am J Obstet Gynecol 191:954–7.

143. Juhasz G, Gyamfi C, Gyamfi P, Tocce K, Stone JL. 2005. Effect of body mass index and excessive weight gain on success of vaginal birth after cesarean delivery. Obstet Gynecol 106:741–6.

144. Hibbard JU, Gilbert S, Landon MB, Hauth JC, Leveno KJ, Spong CY et al. 2006. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Trial of labor or repeat cesarean delivery in women with morbid obesity and previous cesarean delivery. Obstet Gynecol 108: 125–33.

145. Goodall PT, Ahn JT, Chapa JB, Hibbard JU. 2005. Obesity as a risk factor for failed trial of labor in patients with previous cesarean delivery. Am J Obstet Gynecol 192:1423–6.

146. Saravanakumar K, Rao SG, Cooper GM. 2006. The challenges of obesity and obstetric anaesthesia. Curr Opin Obstet Gynecol 18:631–5.

147. Blomberg M. 2011. Maternal obesity and risk of postpartum hemorrhage. Obstet Gynecol 118:561–8.

148. Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD. 2010. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989–2007. Int J Obes (Lond) 34:420–8.

149. Carlson NS, Lowe NK. 2014. Intrapartum management associated with obesity in nulliparous women. J Midwifery Womens Health 59:43–53.

150. Begley CM, Gyte GM, Murphy DJ, Devane D, McDonald SJ, McGuire W. 2010. Active versus expectant management for women in the third stage of labour. Cochrane Database Syst Rev (7): CD007412.

151. Bell J, Bell S, Vahratian A, Awonuga AO. 2011. Abdominal surgical incisions and perioperative morbidity among morbidly obese women undergoing cesarean delivery. Eur J Obstet Gynecol Reprod Biol 154:16–9.

152. Brocato BE, Thorpe EM Jr, Gomez LM, Wan JY, Mari G. 2013. The effect of cesarean delivery skin incision approach in morbidly obese women on the rate of classical hysterotomy. J Pregnancy 2013:890296.

153. Edwards RK, Kumar R, Zhi D, Szychowski J, Subramaniam A, Lefkowitz EJ et al. 2016. Gravidas with class III obesity: evaluating the abdominal skin microbiota above and below the panniculus. J Matern Fetal Neonatal Med 29:3312–6.

154. Houston MC, Raynor BD. 2000. Postoperative morbidity in the morbidly obese parturient woman: supraumbilical and low transverse abdominal approaches. Am J Obstet Gynecol 182:1033–5.

155. Marrs CC, Moussa HN, Sibai BM, Blackwell SC. 2014.The relationship between primary cesarean delivery skin incision type and wound complications in women with morbid obesity. Am J Obstet Gynecol 210:319.e1–4.

156. McLean M, Hines R, Polinkovsky M, Stuebe A, Thorp J, Strauss R. 2012. Type of skin incision and wound complications in the obese parturient. Am J Perinatol 29:301–6.

157. Wall PD, Deucy EE, Glantz JC, Pressman EK. 2003. Vertical skin incisions and wound complications in the obese parturient. Obstet Gynecol 102:952–6.

158. Elman A, Langonnet F, Dixsaut G, Hay JM, Guignard J, Dazza F et al. 1981. Respiratory function is impaired less by transverse than by median vertical supraumbilical incisions. Intensive Care Med 7:235–9.

159. Vaughan RW, Wise L. 1975. Choice of abdominal operative incision in the obese patient: a study using blood gas measurements. Ann Surg 181:829–35.

160. Thornburg LL, Linder MA, Durie DE, Walker B, Pressman EK, Glantz JC. 2012. Risk factors for wound complications in morbidly obese women undergoing primary cesarean delivery. J Matern Fetal Neonatal Med 25:1544–8.

161. Alanis MC, Villers MS, Law TL, Steadman EM, Robinson CJ. 2010. Complications of cesarean delivery in the massively obese parturient. Am J Obstet Gynecol 203:271.e1–7.

162. Myles TD, Gooch J, Santolaya J. 2002. Obesity as an independent risk factor for infectious morbidity in patients who undergo cesarean delivery. Obstet Gynecol 100:959–64.

163. Stamilio DM, Scifres CM. 2014. Extreme obesity and postcesarean maternal complications. Obstet Gynecol 124:227–32.

164. Wolfe HM, Gross TL, Sokol RJ, Bottoms SF, Thompson KL. 1988. Determinants of morbidity in obese women delivered by cesarean. Obstet Gynecol 71:691–6.

165. Tixier H, Thouvenot S, Coulange L, Peyronel C, Filipuzzi L, Sagot P et al. 2009. Cesarean section in morbidly obese women: supra or subumbilical transverse incision? Acta Obstet Gynecol Scand 88:1049–52.

166. Smaill FM, Grivell RM. 2014. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst Rev (10):CD007482.

167. National Institute of Health and Care Excellence. Caesarean Section. Clinical Guideline 132. Manchester, NICE. 2011.

168. Allaire AD, Fisch J, McMahon MJ. 2000. Subcutaneous drain vs. suture in obese women undergoing cesarean delivery. A prospective, randomized trial. J Reprod Med 45:327–31.

169. Cetin A, Cetin M. 1997. Superficial wound disruption after cesarean delivery: effect of the depth and closure of subcutaneous tissue. Int J Gynaecol Obstet 57:17–21.

170. De Vries FE, Wallert ED, Solomkin JS, Allegranzi B, Egger M, Dellinger EP et al. 2016. A systematic review and meta-analysis including GRADE qualification of the risk of surgical site infections after prophylactic negative pressure wound therapy compared with conventional dressings in clean and contaminated surgery. Medicine (Baltimore) 95:e4673.

171. Hellums EK, Lin MG, Ramsey PS. 2007. Prophylactic subcutaneous drainage for prevention of wound complications after cesarean delivery–a metaanalysis. Am J Obstet Gynecol 197: 229–35.

172. Gates S, Anderson ER. 2013. Wound drainage for caesarean section. Cochrane Database Syst Rev (12):CD004549.

173. Hinkson L, Siedentopf JP, Weichert A, Henrich W. 2016. Surgical site infection in cesarean sections with the use of a plastic sheath wound retractor compared to the traditional self-retaining metal retractor. Eur J Obstet Gynecol Reprod Biol 203: 232–8.

174. Scolari Childress KM, Gavard JA, Ward DG, Berger K, Gross GA. 2016. A barrier retractor to reduce surgical site infections and wound disruptions in obese patients undergoing cesarean delivery: a randomized controlled trial. Am J Obstet Gynecol 214:285.e1–10.

175. Garcia AH, Voortman T, Baena CP, Chowdhurry R, Muka T, Jaspers L et al. 2016. Maternal weight status, diet, and supplement use as determinants of breastfeeding and complementary feeding: a systematic review and meta-analysis. Nutr Rev 74: 490–516.

176. Preusting I, Brumley J, Odibo L, Spatz DL, Louis JM. 2017. Obesity as a Predictor of Delayed Lactogenesis II. J Hum Lact 33: 684–91.

177. Keely A, Lawton J, Swanson V, Denison FC. 2015. Barriers to breast-feeding in obese women: a qualitative exploration. Midwifery 31:532–9.

178. Balogun OO, O’Sullivan EJ, McFadden A, Ota E, Gavine A, Garner CD et al. 2016. Interventions for promoting the initiation of breastfeeding. Cochrane Database Syst Rev 11:CD001688.

179. McFadden A, Gavine A, Renfrew MJ, Wade A, Buchanan P, Taylor JL et al. 2017. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev 2: CD001141.

180. Brown D, Baker G, Hoover K. 2013. Breastfeeding tips for women with large breasts. J Hum Lact 29:261–2.

181. Jevitt C, Hernandez I, Gro€er M. 2007. Lactation complicated by overweight and obesity: supporting the mother and newborn. J Midwifery Womens Health 52:606–13.

182. Mok E, Multon C, Piguel L, Barroso E, Goua V, Christin P et al. 2008. Decreased full breastfeeding, altered practices, perceptions, and infant weight change of prepregnant obese women: a need for extra support. Pediatrics 121:e1319–24.

183. Faculty of Sexual & Reproductive Healthcare. UK Medical Eligibility Criteria for Contraceptive Use. London, FSRH. 2016.

184. Faculty of Sexual & Reproductive Healthcare. Contraception After Pregnancy. London, FSRH. 2017.

185. Leermakers EA, Anglin K, Wing RR. 1998.  Reducing postpartum weight retention through a correspondence intervention. Int J Obes Relat Metab Disord 22:1103–9.

186. Lovelady CA, Garner KE, Moreno KL, Williams JP. 2000. The effect of weight loss in overweight, lactating women on the growth of their infants. N Engl J Med 342:449–53.

187. O’Toole ML, Sawicki MA, Artal R. 2003. Structured diet and physical activity prevent postpartum weight retention. J Womens Health (Larchmt) 12:991–8.

188. Bellamy L, Casas JP, Hingorani AD, Williams D. 2009. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta- analysis. Lancet 373:1773–9.

189. Kim C, Newton KM, Knopp RH. 2002. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 25:1862–8.

190. Poston L, Caleyachetty R, Cnattingius S, Corvalan C, Uauy R, Herring S et al. 2016. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol 4:1025–36.

191. Yi XY, Li QF, Zhang J, Wang ZH. 2015. A meta-analysis of maternal and fetal outcomes of pregnancy after bariatric surgery. Int J Gynaecol Obstet 130:3–9. 


192. Galazis N, Docheva N, Simillis C, Nicolaides KH. 2014. Maternal and neonatal outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 181:45–53.

193. Gonzalez I, Lecube A, Rubio MA, Garc ıa-Luna PP. 2016. Pregnancy after bariatric surgery: improving outcomes for mother and child. Int J Womens Health 8:8721–9.

194. Dias MC, Fazio Ede S, de Oliveira FC, Nomura RM, Faintuch J, Zugaib M. 2009. Body weight changes and outcome of pregnancy after gastroplasty for morbid obesity. Clin Nutr 28:169–72.

195. Jans G, Guelinckx I, Voets W, Galjaard S, Van Haard PM, Vansant GM et al. 2014. Vitamin K1 monitoring in pregnancies after bariatric surgery: a prospective cohort study. Surg Obes Relat Dis 10:885–90.

196. Mead NC, Sakkatos P, Sakellaropoulos GC, Adonakis GL, Alexandrides TK, Kalfarentzos F. 2014. Pregnancy outcomes and nutritional indices after 3 types of bariatric surgery performed at a single institution. Surg Obes Relat Dis 10:1166–73.

197. Carreau AM, Nadeau M, Marceau S, Marceau P, Weisnagel SJ. 2017. Pregnancy after bariatric surgery: Balancing risks and benefits. Can J Diabetes 41:432–8.

198. Kominiarek MA. 2011. Preparing for and managing a pregnancy after bariatric surgery. Semin Perinatol 35:356–61.

199. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM et al. 2013. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient–2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring) 21 Suppl 1:S1–27.

200. Devlieger R, Guelinckx I, Jans G, Voets W, Vanholsbeke C, Vansant G. 2014. Micronutrient levels and supplement intake in pregnancy after bariatric surgery: a prospective cohort study. PLoS ONE 9:e114192.

201. Vahratian A, Zhang J, Troendle JF, Savitz DA, Siega-Riz AM. 2004. Maternal prepregnancy overweight and obesity and the pattern of labor progression in term nulliparous women. Obstet Gynecol 104:943–51.

202. Chu SY, Kim SY, Lau J, Schmid CH, Dietz PM, Callaghan WM et al. 2007. Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol 197:223–8.