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Changes in prepregnancy body mass index between the first and second pregnancies and risk of large-for-gestational-age birth.
Am J Obstet Gynecol. 2007 Jun; 196(6):530.e1-8.AJ

Abstract

OBJECTIVE

The objective of our study was to determine whether changes in prepregnancy body mass index (BMI) between the first 2 pregnancies is associated with increased risk for large-for-gestational-age (LGA) birth in the second pregnancy.

STUDY DESIGN

A population-based, retrospective cohort analysis was performed using the Missouri 1989-1997 longitudinally linked data. Women with the first 2 consecutive singleton live births (n = 146,227) were analyzed. BMI (kilograms per square meter) was categorized as underweight (less than 18.5), normal (18.5 to 24.9), overweight (25 to 29.9), and obese (30 or greater), and LGA was defined as gestational age-specific birthweight greater than the 90th centile. Multivariate logistic regression analysis was used to estimate the odds ratio (OR) with 95% confidence interval (CI). Population attributable fraction for LGA births was calculated.

RESULTS

Compared to women with normal BMI in their first and second pregnancies, overweight-overweight (OR 1.7, 95% CI 1.6, 1.8) and obese-obese (OR 2.3, 95% CI 2.2, 2.4) women in their first and second pregnancies were at increased risk of LGA births. Any increase in BMI from normal to obese between pregnancies increased LGA risk (OR 1.6 to 2.0), whereas any decrease in BMI from obese to normal attenuated the risk (OR 1.3 to 1.7). 17.1%, 13.2%, and 7.6% of LGA births are likely preventable had BMI not increased from first pregnancy underweight, normal, and overweight, respectively.

CONCLUSION

In comparison with women with normal BMI in both pregnancies, any increase or decrease in prepregnancy BMI between normal and obese is associated with increased risk of LGA birth. A modification in the risk of LGA births by long-term maternal BMI status or maternal genetic factors appears likely.

Authors+Show Affiliations

Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08901-1977, USA. getahuda@umdnj.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17547882

Citation

Getahun, Darios, et al. "Changes in Prepregnancy Body Mass Index Between the First and Second Pregnancies and Risk of Large-for-gestational-age Birth." American Journal of Obstetrics and Gynecology, vol. 196, no. 6, 2007, pp. 530.e1-8.
Getahun D, Ananth CV, Peltier MR, et al. Changes in prepregnancy body mass index between the first and second pregnancies and risk of large-for-gestational-age birth. Am J Obstet Gynecol. 2007;196(6):530.e1-8.
Getahun, D., Ananth, C. V., Peltier, M. R., Salihu, H. M., & Scorza, W. E. (2007). Changes in prepregnancy body mass index between the first and second pregnancies and risk of large-for-gestational-age birth. American Journal of Obstetrics and Gynecology, 196(6), e1-8.
Getahun D, et al. Changes in Prepregnancy Body Mass Index Between the First and Second Pregnancies and Risk of Large-for-gestational-age Birth. Am J Obstet Gynecol. 2007;196(6):530.e1-8. PubMed PMID: 17547882.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in prepregnancy body mass index between the first and second pregnancies and risk of large-for-gestational-age birth. AU - Getahun,Darios, AU - Ananth,Cande V, AU - Peltier,Morgan R, AU - Salihu,Hamisu M, AU - Scorza,William E, PY - 2006/07/31/received PY - 2006/11/17/revised PY - 2006/12/28/accepted PY - 2007/6/6/pubmed PY - 2007/10/16/medline PY - 2007/6/6/entrez SP - 530.e1 EP - 8 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 196 IS - 6 N2 - OBJECTIVE: The objective of our study was to determine whether changes in prepregnancy body mass index (BMI) between the first 2 pregnancies is associated with increased risk for large-for-gestational-age (LGA) birth in the second pregnancy. STUDY DESIGN: A population-based, retrospective cohort analysis was performed using the Missouri 1989-1997 longitudinally linked data. Women with the first 2 consecutive singleton live births (n = 146,227) were analyzed. BMI (kilograms per square meter) was categorized as underweight (less than 18.5), normal (18.5 to 24.9), overweight (25 to 29.9), and obese (30 or greater), and LGA was defined as gestational age-specific birthweight greater than the 90th centile. Multivariate logistic regression analysis was used to estimate the odds ratio (OR) with 95% confidence interval (CI). Population attributable fraction for LGA births was calculated. RESULTS: Compared to women with normal BMI in their first and second pregnancies, overweight-overweight (OR 1.7, 95% CI 1.6, 1.8) and obese-obese (OR 2.3, 95% CI 2.2, 2.4) women in their first and second pregnancies were at increased risk of LGA births. Any increase in BMI from normal to obese between pregnancies increased LGA risk (OR 1.6 to 2.0), whereas any decrease in BMI from obese to normal attenuated the risk (OR 1.3 to 1.7). 17.1%, 13.2%, and 7.6% of LGA births are likely preventable had BMI not increased from first pregnancy underweight, normal, and overweight, respectively. CONCLUSION: In comparison with women with normal BMI in both pregnancies, any increase or decrease in prepregnancy BMI between normal and obese is associated with increased risk of LGA birth. A modification in the risk of LGA births by long-term maternal BMI status or maternal genetic factors appears likely. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/17547882/Changes_in_prepregnancy_body_mass_index_between_the_first_and_second_pregnancies_and_risk_of_large_for_gestational_age_birth_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(06)02481-1 DB - PRIME DP - Unbound Medicine ER -