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Maternal obesity and excessive maternal weight gain during pregnancy: effects on outcomes after neonatal cardiac surgical procedures

Published online by Cambridge University Press:  14 December 2017

Rocky Tsang ,
Pamela Hilvers ,
Philip J. Lupo ,
Ronald Bronicki ,
Dean McKenzie  and
Paul A. Checchia
Rocky Tsang
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
Pamela Hilvers
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
Philip J. Lupo
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
Ronald Bronicki
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
Dean McKenzie
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
Paul A. Checchia*
Affiliation:
Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
*
Correspondence to: Professor P. A. Checchia, MD, FCCM, FACC, Department of Pediatrics, Critical Care and Cardiology, Cardiovascular Intensive Care Unit, Section of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, 6621 Fannin Street, Suite W6006, Houston, TX 77030, United States of America. Tel: +(832) 826 6214; Fax: +(832) 825 6229; E-mail: checchia@bcm.edu
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Abstract

Introduction

Maternal obesity is associated with an increased risk for adverse perinatal outcomes. Obesity is also associated with a chronic inflammatory state and metabolic derangements that affect the newborn. The additional use of cardiopulmonary bypass during the neonatal period could impact the systemic inflammatory response in the immediate postoperative period that manifests as cardiac depression and multi-organ dysfunction. This study aimed to determine the association of maternal obesity and excessive weight gain during pregnancy with the immediate postoperative morbidity of neonatal patients undergoing cardiopulmonary bypass.

Methods

A retrospective review of neonates who underwent cardiopulmonary bypass within the first 30 days of life at our institution between 2011 and 2013 was conducted. Postoperative variables investigated included the duration of length of mechanical ventilation, length of stay in the ICU, peak vasoactive inotrope scores, and peak lactate level. Maternal obesity was defined as 1st trimester body mass index ⩾30 kg/m2. Excessive weight gain was defined as ⩾12 kg gained during pregnancy. In order to determine the association between maternal obesity or excessive weight gain and postoperative variables, we used multiple linear regression, adjusting for birth weight and risk adjustment for congenital heart surgery score.

Results

Records from 58 mother–baby dyads were examined. After controlling for birth weight and risk adjustment for congenital heart surgery score, there were no significant associations between maternal obesity and excessive weight gain during pregnancy versus all postoperative outcomes measured.

Conclusion

Despite the known negative impact of maternal obesity on perinatal outcomes, we were unable to find associations between maternal obesity and excessive weight gain during pregnancy versus postoperative outcomes.

Keywords

Cardiopulmonary bypassobesitymaternal obesitycardiac surgerypaediatric
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 3 , March 2018 , pp. 391 - 396
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Copyright
© Cambridge University Press 2017 

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