Characterization of cardiometabolic risk in pregnant women of advanced maternal age with obesity and its impact on perinatal outcomes

Abstract

Introduction: Obesity and advanced maternal age are independent risk factors for gestational complications. Their combination could potentiate adverse outcomes. Objective: to characterize the cardiometabolic risk and determine its association with perinatal outcomes in pregnant women with obesity aged 35 years or older. Methods: An observational, analytical and cross-sectional study was carried out at the Provincial Hospital of Villa Clara (2022-2023). From a sample of 404 pregnant women with a body mass index ≥25 kg/m², the subgroup of 89 women aged 35 years or older was analyzed. Anthropometric and biochemical indicators were evaluated, and the strength of association (Odds Ratio) with perinatal complications was calculated. Results: Older pregnant women showed a higher prevalence of severe obesity (18.0% vs. 8.9%, p=0.015), visceral adiposity (waist circumference >88 cm: 92.1% vs. 80.0%, p=0.007) and hypertriglyceridemia (75.3% vs. 56.8%, p=0.001). The combination of age ≥35 years and class II-III obesity showed a significant association with fetal death (OR=6.2; 95% CI: 1.2-31.0). Conclusions: Pregnant women aged 35 years or older with obesity, especially in severe degrees, constitute an extreme risk subgroup. A synergy between age and visceral obesity is evidenced, which potentiates the strength of association for serious perinatal complications, demanding a differentiated and intensive clinical management.