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Pre-pregnancy BMI and weight gain: where is the tipping point for preterm birth?

Abstract

BACKGROUND

Obesity in pregnant women is a major problem affecting both the mother and her offspring. Literature on the effect of obesity on preterm birth is inconsistent and few studies have investigated the influence of weight gain during pregnancy. This study examined the effect of maternal pre-pregnancy BMI and weight gain during pregnancy on preterm birth.

METHODS

Data from the Collaborative Perinatal Project (CPP) on 45,824 pregnant women with singleton, live-born infants with no sever congenital anomalies was analyzed. Primary outcome variables included preterm (< 37 weeks of gestation), categorized into spontaneous preterm with and without premature rupture of membrane (PROM) and indicated preterm. Maternal BMI was categorized into underweight (BMI < 18.50), normal weight (BMI =1 8.50 - 24.99), overweight (BMI = 25.00 - 29.99), and obese (BMI ≥ 30.00). Multinomial regression analysis was conducted and OR and 95% CI were calculated.

RESULTS

The rate of spontaneous preterm birth with PROM among overweight women decreased with increasing weight gain but increased among women who had excessive weight gain. Similarly, a U-shaped rate of spontaneous preterm birth with and without PROM was observed in obese women. Gaining less weight was protective of spontaneous preterm with and without PROM among overweight and obese women compared to normal weight women. Among underweight women, gaining < 7 kg or 9.5-12.7 kg was associated with increased odds of indicated preterm birth. Appreciable differences were also observed in the association between pre-pregnancy BMI, gestational weight gain and the subtypes of preterm births among African Americans and Caucasian Americans.

CONCLUSION

Reduced weight gain during pregnancy among overweight and obese women is associated with reduced spontaneous preterm birth with and without PROM. Health care professionals and public health workers should be aware of this risk and adhere to the 2009 IOM guideline that recommended reduced weight gain during pregnancy for obese and overweight women.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23706121

Citation

Masho, Saba W., et al. "Pre-pregnancy BMI and Weight Gain: Where Is the Tipping Point for Preterm Birth?" BMC Pregnancy and Childbirth, vol. 13, 2013, p. 120.
Masho SW, Bishop DL, Munn M. Pre-pregnancy BMI and weight gain: where is the tipping point for preterm birth? BMC Pregnancy Childbirth. 2013;13:120.
Masho, S. W., Bishop, D. L., & Munn, M. (2013). Pre-pregnancy BMI and weight gain: where is the tipping point for preterm birth? BMC Pregnancy and Childbirth, 13, p. 120. doi:10.1186/1471-2393-13-120.
Masho SW, Bishop DL, Munn M. Pre-pregnancy BMI and Weight Gain: Where Is the Tipping Point for Preterm Birth. BMC Pregnancy Childbirth. 2013 May 24;13:120. PubMed PMID: 23706121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-pregnancy BMI and weight gain: where is the tipping point for preterm birth? AU - Masho,Saba W, AU - Bishop,Diane L, AU - Munn,Meaghan, Y1 - 2013/05/24/ PY - 2012/07/27/received PY - 2013/05/20/accepted PY - 2013/5/28/entrez PY - 2013/5/28/pubmed PY - 2015/4/15/medline SP - 120 EP - 120 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 13 N2 - BACKGROUND: Obesity in pregnant women is a major problem affecting both the mother and her offspring. Literature on the effect of obesity on preterm birth is inconsistent and few studies have investigated the influence of weight gain during pregnancy. This study examined the effect of maternal pre-pregnancy BMI and weight gain during pregnancy on preterm birth. METHODS: Data from the Collaborative Perinatal Project (CPP) on 45,824 pregnant women with singleton, live-born infants with no sever congenital anomalies was analyzed. Primary outcome variables included preterm (< 37 weeks of gestation), categorized into spontaneous preterm with and without premature rupture of membrane (PROM) and indicated preterm. Maternal BMI was categorized into underweight (BMI < 18.50), normal weight (BMI =1 8.50 - 24.99), overweight (BMI = 25.00 - 29.99), and obese (BMI ≥ 30.00). Multinomial regression analysis was conducted and OR and 95% CI were calculated. RESULTS: The rate of spontaneous preterm birth with PROM among overweight women decreased with increasing weight gain but increased among women who had excessive weight gain. Similarly, a U-shaped rate of spontaneous preterm birth with and without PROM was observed in obese women. Gaining less weight was protective of spontaneous preterm with and without PROM among overweight and obese women compared to normal weight women. Among underweight women, gaining < 7 kg or 9.5-12.7 kg was associated with increased odds of indicated preterm birth. Appreciable differences were also observed in the association between pre-pregnancy BMI, gestational weight gain and the subtypes of preterm births among African Americans and Caucasian Americans. CONCLUSION: Reduced weight gain during pregnancy among overweight and obese women is associated with reduced spontaneous preterm birth with and without PROM. Health care professionals and public health workers should be aware of this risk and adhere to the 2009 IOM guideline that recommended reduced weight gain during pregnancy for obese and overweight women. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/23706121/Pre_pregnancy_BMI_and_weight_gain:_where_is_the_tipping_point_for_preterm_birth L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-13-120 DB - PRIME DP - Unbound Medicine ER -