Es conocido que la obesidad durante el embarazo entraña mayor riesgo de sufrir complicaciones durante el embarazo. Nuevos datos se añaden a lo ya sabido: los costes económicos asistenciales se incrementan.

Las gestantes obesas tienden a tener estancias hospitalarias más prolongadas, precisan más cantidad de medicamentos, y mayor número de consultas profesionales. La mayor parte de estas variables se relaciona con la hipertensión, preeclampsia y cesáreas. La epidemióloga Susan Y. Chu, del U.S. Centers for Disease Control and Prevention, dice que en EEUU se producen 4 millones de nacimientos, lo cual representa un millón de gestantes obesas, de manera que los gastos sanitarios se han incrementado de forma considerable. La investigadora analizó más de 13.000 nacimientos producidos entre 2000 y 2004 y relacionaro la obesidad con el uso de sistemas sanitarios. Para la mayoría de obesas la estancia hospitalaria fue 4,1 día más larga que las mujeres de peso normal, y se debió en gran parte al mayor número de cesáreas. Además, las obesas mayor número de pruebas, ecografías, medicamentos, mayor número de consultas ordinarias. En los comentarios añadidos se destacan los efectos nocivos y su relación con la introducción de la comida basura en los últimos 50 años.

N Engl J Med. 2008 Apr 3;358(14):1444-53.Click here to read Association between obesity during pregnancy and increased use of health care. Chu SY, Bachman DJ, Callaghan WM, Whitlock EP, Dietz PM, Berg CJ, O'Keeffe-Rosetti M, Bruce FC, Hornbrook MC.

National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.

BACKGROUND: In the United States, obesity during pregnancy is common and increases obstetrical risks. An estimate of the increase in use of health care services associated with obesity during pregnancy is needed. METHODS: We used electronic data systems of a large U.S. group-practice health maintenance organization to identify 13,442 pregnancies among women 18 years of age or older at the time of conception that resulted in live births or stillbirths. The study period was between January 1, 2000, and December 31, 2004. We assessed associations between measures of use of health care services and body-mass index (BMI, defined as the weight in kilograms divided by the square of the height in meters) before pregnancy or in early pregnancy. The women were categorized as underweight (BMI <18.5), normal (BMI 18.5 to 24.9), overweight (BMI 25.0 to 29.9), obese (BMI 30.0 to 34.9), very obese (BMI 35.0 to 39.9), or extremely obese (BMI > or =40.0). The primary outcome was the mean length of hospital stay for delivery. RESULTS: After adjustment for age, race or ethnic group, level of education, and parity, the mean (+/-SE) length of hospital stay for delivery was significantly (P<0.05) greater among women who were overweight (3.7+/-0.1 days), obese (4.0+/-0.1 days), very obese (4.1+/-0.1 days), and extremely obese (4.4+/-0.1 days) than among women with normal BMI (3.6+/-0.1 days). A higher-than-normal BMI was associated with significantly more prenatal fetal tests, obstetrical ultrasonographic examinations, medications dispensed from the outpatient pharmacy, telephone calls to the department of obstetrics and gynecology, and prenatal visits with physicians. A higher-than-normal BMI was also associated with significantly fewer prenatal visits with nurse practitioners and physician assistants. Most of the increase in length of stay associated with higher BMI was related to increased rates of cesarean delivery and obesity-related high-risk conditions. CONCLUSIONS: Obesity during pregnancy is associated with increased use of health care services. Copyright 2008 Massachusetts Medical Society.