Objective. To determine whether maternal obesity in early pregnancy is associated with low neonatal 5-min Apgar scores while adjusting for confounders.

Methods. Data were obtained from Maine State Birth Records Database. Analyses were restricted to information on 58,089 white women and their newborns. Maternal weight status was defined using the recorded early second trimester maternal body mass index (BMI) and defined as normal weight (BMI <25), overweight (BMI 25 to <30), obese (BMI 30 to <40), and morbidly obese (BMI ≥40). Logistic regression analysis was used to assess the association of maternal weight status with low Apgar score while adjusting for confounders.

Results. Compared with newborns of normal weight women, the risk to receive low Apgar scores (4–6) is increased in newborns of obese (OR 1.4, 95% CI 1.1–1.7) and morbidly obese mothers (OR 2.0, 95% CI 1.5–2.7). The association did not achieve significance for newborns of overweight mothers (OR 1.2, 95% CI 0.99–1.4). No association was identified between maternal weight status and very low Apgar scores (0–3).

Conclusions. Maternal obesity is associated with a significantly increased risk for decreased Apgar scores at birth. Further studies are needed to clarify the relationships among maternal obesity, complications of pregnancy, and neonatal outcome.