Original Study| Volume 32, ISSUE 2, P139-145, April 2019

Adverse Neonatal Outcomes in Overweight and Obese Adolescents Compared with Normal Weight Adolescents and Low Risk Adults

Published:November 16, 2018DOI:


      Study Objective

      To evaluate the association between maternal body mass index and neonatal outcomes in adolescents and to compare neonatal outcomes between overweight and obese adolescents and obstetric low-risk adult women.


      Retrospective cohort study using data from the Swedish Medical Birth Register.




      All 31,386 primiparous adolescents younger than 20 years of age and 178,844 “standard” women, defined as normal weight, obstetric low-risk adult women who delivered between 1992 and 2013. The adolescents were categorized according to weight and height in early pregnancy into body mass index groups according to the World Health Organization classification. Logistic regression models were used.

      Interventions and Main Outcome Measures

      Neonatal outcomes in relation to maternal body mass index groups.


      In the adolescents, 6109/31,386 (19.5%) and 2287/31,386 (7.3%) were overweight and obese, respectively. Compared with normal weight adolescents, overweight adolescents had a lower risk of having small for gestational age neonates, and higher risks for having neonates with macrosomia, and being large for gestational age and with Apgar score less than 7 at 5 minutes. The obese adolescents had increased risk for having neonates being large for gestational age (3.8% vs 1.3%; adjusted odds ratio [aOR], 2.97 [95% confidence interval (CI), 2.30-3.84]), with macrosomia (>4500 g) (4.6% vs 1.4%; aOR, 2.95 [95% CI, 2.33-3.73]), and with Apgar score less than 7 at 5 minutes (2.2% vs 1.1%; aOR, 1.98 [95% CI, 1.43-2.76]) than normal weight adolescents. Compared with the standard women, overweight and obese adolescents had overall more adverse neonatal outcomes.


      Overweight and obese adolescents had predominantly increased risks for adverse neonatal outcomes compared with normal weight adolescents and standard women.

      Key Words

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        • World Health Organization
        Adolescent pregnancy fact sheet.
        • The National Board of Health and Welfare, Sweden
        Statistics on pregnancies, deliveries and newborn infants 2016.
        • Tyrberg R.B.
        • Blomberg M.
        • Kjølhede P.
        Deliveries among teenage women- with emphasis on incidence and mode of delivery: a Swedish national survey from 1973-2010.
        BMC Pregnancy Childbirth. 2013; 13: 204
        • Blomberg M.
        • Tyrberg R.B.
        • Kjølhede P.
        Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study.
        BMJ Open. 2014; 4: e005840
        • Gupta N.
        • Kiran U.
        • Bhal K.
        Teenage pregnancies: obstetric characteristics and outcome.
        Eur J Obstet Gynecol Reprod Biol. 2008; 137: 165
        • Foo X.Y.
        • Geer R.M.
        • Kumar S.
        Impact of maternal body mass index on intrapartum and neonatal outcomes in Brisbane, Australia 2007 to 2013.
        Birth. 2016; 43: 358
        • Cedergren M.I.
        Maternal morbid obesity and the risk of adverse pregnancy outcome.
        Obstet Gynecol. 2004; 103: 219
        • Blomberg M.
        Maternal obesity, mode of delivery, and neonatal outcome.
        Obstet Gynecol. 2013; 122: 50
        • NCD Risk Factor Collaboration (NCD-RisC)
        Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults.
        Lancet. 2017; 390: 2627
        • World Health Organization
        Obesity and overweight fact sheet.
        • Ekblom Ö.B.
        • Ekblom Bak E.A.M.
        • Ekblom B.T.
        Trends in body mass index in Swedish adolescents between 2001 and 2007.
        Acta Paediatr. 2009; 98: 519
        • Sukalich S.
        • Mingione M.J.
        • Glantz J.C.
        Obstetric outcomes in overweight and obese adolescents.
        Am J Obstet Gynecol. 2006; 195: 851
        • Halloran D.R.
        • Marshall N.E.
        • Kunovich R.M.
        • et al.
        Obesity trends and perinatal outcomes in black and white teenagers.
        Am J Obstet Gynecol. 2012; 207 (492.e1)
        • Haeri S.
        • Guichard I.
        • Baker A.M.
        • et al.
        The effect of teenage maternal obesity on perinatal outcomes.
        Obstet Gynecol. 2009; 113: 300
        • Kansu-Celik H.
        • Kisa Karakaya B.
        • Guzel I.A.
        • et al.
        To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women.
        J Matern Fetal Neonatal Med. 2017; 30: 1574
        • Swedish National Board of Health and Welfare
        The Swedish Medical Birth Register: a summary of content and quality.
        • World Health Organization
        Obesity: preventing and managing the global epidemic: report of a WHO consultation.
        • Marsal K.
        • Persson P.H.
        • Larsen T.
        • et al.
        Intrauterine growth curves based on ultrasonically estimated foetal weights.
        Acta Paediatr. 1996; 85: 843
        • Cole T.J.
        • Bellizzi M.C.
        • Flegal K.M.
        • et al.
        Establishing a standard definition for child overweight and obesity worldwide: international survey.
        BMJ. 2000; 320: 1240
        • Boulet S.L.
        • Alexander G.R.
        • Salihu H.M.
        • et al.
        Macrosomic births in the United States: determinants, outcomes, and proposed grades of risk.
        Am J Obstet Gynecol. 2003; 188: 1372
        • Harder T.
        • Rodekamp E.
        • Schellong K.
        • et al.
        Birth weight and subsequent risk of type 2 diabetes: a meta-analysis.
        Am J Epidemiol. 2007; 165: 849
        • Rogers I.
        The influence of birthweight and intrauterine environment on adiposity and fat distribution in later life.
        Int J Obes Relat Metab Disord. 2003; 27: 755
        • Chen M.
        • McNiff C.
        • Madan J.
        • et al.
        Maternal obesity and neonatal Apgar scores.
        J Matern Fetal Neonatal Med. 2010; 23: 89
        • Ramö Isgren A.
        • Kjølhede P.
        • Blomberg M.
        Obstetric outcomes in adolescents related to body mass index and compared with low-risk adult women.
        J Womens Health. 2017; 26: 426