ORIGINAL ARTICLE 453 SUMMARY Objective: To analyze the association between maternal obesity and postnatal infectious complications in high-risk pregnancies. Methods: Prospective study from August 2009 through August 2010 with the following inclusion criteria: women up to the 5 th post- partum day; age ≥ 18 years; high-risk pregnancy; singleton pregnancy with live fetus at labor onset; delivery at the institution; maternal weight measured on day of delivery. he nutritional status in late pregnancy was assessed by the body mass index (BMI), with the application of the Atalah et al. curve. Patients were graded as underweight, adequate weight, overweight, or obese. Postpartum complications investigated during the hospital stay and 30 days post-discharge were: surgical wound infection and/or se- cretion, urinary infection, postpartum infection, fever, hospitalization, antibiotic use, and composite morbidity (at least one of the complications mentioned). Results: 374 puerperal women were included, graded according to the inal BMI as: underweight (n = 54, 14.4%); adequate weight (n = 126, 33.7%); overweight (n = 105, 28.1%); and obese (n = 89, 23.8%). Maternal obesity was shown to have a signiicant association with the following postpartum complications: surgical wound infection (16.7%, p = 0.042), urinary infection (9.0%, p = 0.004), antibiotic use (12.3%, p < 0.001), and composite morbidity (25.6%, p = 0.016). By applying the logistic regression model, obesity in late pregnancy was found to be an independent variable regardless of the composite morbid- ity predicted (OR: 2.09; 95% CI: 1.15-3.80, p = 0.015). Conclusion: Maternal obesity during late pregnancy in high-risk patients is independently associated with postpartum infectious complications, which demonstrates the need for a closer follow-up of mater- nal weight gain in these pregnancies. Keywords: Nutritional status; obesity; pregnancy; postpartum period; high-risk preg- nancy; puerperal infection. ©2012 Elsevier Editora Ltda. All rights reserved. Study conducted at the Discipline of Obstetrics, Department of Obstetrics and Gynecology, Medical School, Universidade de São Paulo, São Paulo, and at the Nutrition and Dietetics Division, Nutrology Group, Clinical Hospital, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil Submitted on: 09/21/2011 Approved on: 02/19/2012 Financial support: Master’s scholarship to the student Letícia Vieira de Paiva granted by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Correspondence to: Roseli Mieko Yamamoto Nomura Av. Dr. Eneas de Carvalho Aguiar, 255 10º andar, sala 10037 São Paulo – SP, Brazil CEP: 05403-000 roseli.nomura@hotmail.com Conflicts of interest: None. Maternal obesity in high-risk pregnancies and postpartum infectious complications LETÍCIA VIEIRA DE PAIVA 1 , ROSELI MIEKO YAMAMOTO NOMURA 2 , MARIA CAROLINA GONÇALVES DIAS 3 , MARCELO ZUGAIB 4 1 Nutritionist, Postgraduate Program Student, USP, São Paulo, SP, Brazil 2 Associate Professor, Universidade de São Paulo (USP), São Paulo, SP, Brazil 3 MSc in Applied Human Nutrition, USP; Nutritionist, Central Institute, Clinical Hospital, Medical School, USP, São Paulo, SP, Brazil 4 Full Professor, Medical School, USP, São Paulo, SP, Brazil