The purpose of study is to evaluate whether weekly antenatal testing in pregnant women with body mass index (BMI) 30-40 in the third trimester is associated with earlier delivery when compared to growth ultrasounds every 4 weeks. The investigators will also assess the differences in maternal and neonatal outcomes between the groups.
Over the last decade, the prevalence of obesity has dramatically increased in women in reproductive age. It is well known that obesity has been associated with increased risk of antenatal complications, maternal and perinatal morbidity, including higher risk of stillbirth. Studies including obese women without other antepartum comorbidities have shown that up to 11% of pregnancies are complicated with fluid and fetal growth abnormalities. According to American College of Obstetricians and Gynecologists (ACOG) guidelines, antepartum surveillance has not been proven to improve pregnancy outcomes in such cases and no specific recommendations for antepartum surveillance in obese women have been established.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
6
Includes a regular growth ultrasound examination.
Includes weekly ultrasounds with a biophysical profile, which measures fetal tone, fetal movements, fetal breathing and amount of amniotic fluid (water around baby).
Columbia Univeristy Irving Medical Center
New York, New York, United States
Average gestational age at delivery of participating women's babies
This is to measure the number of weeks that the baby has been in the uterus. It is measured from the first day of the woman's last menstrual cycle to the date of delivery. A normal pregnancy can range from 38 to 42 weeks. A significant delay in gestational age of delivery would be \> 7 days out of this range.
Time frame: At time of delivery
Average birth weight of participating women's babies
This is to measure the body weight of a baby at birth. The average baby weighs about 7.5 pounds - though the range of normal is between 5.8 and 10 pounds.
Time frame: At time of delivery
Number of participating women who experienced composite maternal morbidity
Composite maternal morbidity is defined as any of the following: chorioamnionitis, endometritis, cesarean section in labor, wound infection, transfusion, hemorrhage, deep venous thrombosis or pulmonary embolism, admission to ICU or death.
Time frame: At time of delivery
Number of participating women whose babies experienced composite neonatal morbidity
Composite neonatal morbidity is defined as any of the following: stillbirth after randomization, neonatal death within 28 days from birth, respiratory distress syndrome, Transient tachypnea of the newborn, hypoglycemia, sepsis, seizures, necrotizing enterocolitis, hypoxic ischemic encephalopathy, cardiopulmonary resuscitation or ventilator support within 24 h of birth, arterial blood pH\<7, 5 min Apgar score \<3, ICU admission, prolonged hospitalization (5 days or longer).
Time frame: At time of delivery
Number of participating women whose babies experienced composite of abnormalities of fluid volume and growth
A composite of abnormalities of fluid volume and growth is defined as any of the following: oligohydramnios (AFI\<5 or maximum vertical pocket (MVP) \< 2) or polyhydramnios (AFI\>24 or MVP\>8); fetal growth restriction (EFW\<10% or AC\<5%) ; or large for gestational age (EFW\>90%), macrosomia (EFW\>4,000 grams).
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Time frame: At time of delivery