S S Kim1,2, P Mendola1, Y Zhu1,3, B S Hwang4,5, K L Grantz1. 1. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA. 2. Division of Epidemiology and Health Index, Korea National Institute of Health, Cheongju-si, Chungcheongbuk-do, Korea. 3. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. 4. Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA. 5. Department of Applied Statistics, Chung-Ang University, Seoul, Korea.
Abstract
OBJECTIVE: To investigate the independent impact of prepregnancy obesity on preterm delivery among women without chronic diseases by gestational age, preterm category and parity. DESIGN: A retrospective cohort study. SETTING: Data from the Consortium on Safe Labor (CSL) in the USA (2002-08). POPULATION: Singleton deliveries at ≥23 weeks of gestation in the CSL (43 200 nulliparas and 63 129 multiparas) with a prepregnancy body mass index (BMI) ≥18.5 kg/m2 and without chronic diseases. METHODS: Association of prepregnancy BMI and the risk of preterm delivery was examined using Poisson regression with normal weight as reference. MAIN OUTCOME MEASURES: Preterm deliveries were categorised by gestational age (extremely, very, moderate to late) and category (spontaneous, indicated, no recorded indication). RESULTS: Relative risk of spontaneous preterm delivery was increased for extremely preterm among obese nulliparas (1.26, 95% CI: 0.94-1.70 for overweight; 1.88, 95% CI: 1.30-2.71 for obese class I; 1.99, 95% CI: 1.32-3.01 for obese class II/III) and decreased for moderate to late preterm delivery among overweight and obese multiparas (0.90, 95% CI: 0.83-0.97 for overweight; 0.87, 95% CI: 0.78-0.97 for obese class I; 0.79, 95% CI: 0.69-0.90 for obese class II/III). Indicated preterm delivery risk was increased with prepregnancy BMI in a dose-response manner for extremely preterm and moderate to late preterm among nulliparas, as it was for moderate to late preterm delivery among multiparas. CONCLUSIONS: Prepregnancy BMI was associated with increased risk of preterm delivery even in the absence of chronic diseases, but the association was heterogeneous by preterm categories, gestational age and parity. TWEETABLE ABSTRACT: Obese nulliparas without chronic disease had higher risk for spontaneous delivery <28 weeks of gestation.
OBJECTIVE: To investigate the independent impact of prepregnancy obesity on preterm delivery among women without chronic diseases by gestational age, preterm category and parity. DESIGN: A retrospective cohort study. SETTING: Data from the Consortium on Safe Labor (CSL) in the USA (2002-08). POPULATION: Singleton deliveries at ≥23 weeks of gestation in the CSL (43 200 nulliparas and 63 129 multiparas) with a prepregnancy body mass index (BMI) ≥18.5 kg/m2 and without chronic diseases. METHODS: Association of prepregnancy BMI and the risk of preterm delivery was examined using Poisson regression with normal weight as reference. MAIN OUTCOME MEASURES: Preterm deliveries were categorised by gestational age (extremely, very, moderate to late) and category (spontaneous, indicated, no recorded indication). RESULTS: Relative risk of spontaneous preterm delivery was increased for extremely preterm among obese nulliparas (1.26, 95% CI: 0.94-1.70 for overweight; 1.88, 95% CI: 1.30-2.71 for obese class I; 1.99, 95% CI: 1.32-3.01 for obese class II/III) and decreased for moderate to late preterm delivery among overweight and obese multiparas (0.90, 95% CI: 0.83-0.97 for overweight; 0.87, 95% CI: 0.78-0.97 for obese class I; 0.79, 95% CI: 0.69-0.90 for obese class II/III). Indicated preterm delivery risk was increased with prepregnancy BMI in a dose-response manner for extremely preterm and moderate to late preterm among nulliparas, as it was for moderate to late preterm delivery among multiparas. CONCLUSIONS: Prepregnancy BMI was associated with increased risk of preterm delivery even in the absence of chronic diseases, but the association was heterogeneous by preterm categories, gestational age and parity. TWEETABLE ABSTRACT: Obese nulliparas without chronic disease had higher risk for spontaneous delivery <28 weeks of gestation.
Authors: Israel Hendler; Robert L Goldenberg; Brian M Mercer; Jay D Iams; Paul J Meis; Atef H Moawad; Cora A MacPherson; Steve N Caritis; Menachem Miodovnik; Kate M Menard; Gary R Thurnau; Yoram Sorokin Journal: Am J Obstet Gynecol Date: 2005-03 Impact factor: 8.661
Authors: Julia Warner Gargano; Claudia Holzman; Patricia Senagore; Poul Thorsen; Kristin Skogstrand; David M Hougaard; Mohammad H Rahbar; Hwan Chung Journal: J Reprod Immunol Date: 2008-09-23 Impact factor: 4.054
Authors: Kelly K Ferguson; Thomas F McElrath; Yin-Hsiu Chen; Bhramar Mukherjee; John D Meeker Journal: Am J Reprod Immunol Date: 2014-05-08 Impact factor: 3.886
Authors: Catherine Y Spong; Brian M Mercer; Mary D'Alton; Sarah Kilpatrick; Sean Blackwell; George Saade Journal: Obstet Gynecol Date: 2011-08 Impact factor: 7.623
Authors: Margaret G Parker; Fengxiu Ouyang; Colleen Pearson; Matthew W Gillman; Mandy B Belfort; Xiumei Hong; Guoying Wang; Linda Heffner; Barry Zuckerman; Xiaobin Wang Journal: BMC Pregnancy Childbirth Date: 2014-04-30 Impact factor: 3.007
Authors: Kartik K Venkatesh; Robert A Strauss; Daniel J Westreich; John M Thorp; David M Stamilio; Katherine L Grantz Journal: Pregnancy Hypertens Date: 2020-03-10 Impact factor: 2.899
Authors: Yeyi Zhu; Monique M Hedderson; Susan D Brown; Sylvia E Badon; Juanran Feng; Charles P Quesenberry; Assiamira Ferrara Journal: Am J Clin Nutr Date: 2021-08-02 Impact factor: 8.472
Authors: Yassaman Vafai; Edwina H Yeung; Rajeshwari Sundaram; Melissa M Smarr; Nicole Gerlanc; William A Grobman; Daniel Skupski; Edward K Chien; Stefanie N Hinkle; Roger B Newman; Deborah A Wing; Angela C Ranzini; Anthony Sciscione; Jagteshwar Grewal; Cuilin Zhang; Katherine L Grantz Journal: J Matern Fetal Neonatal Med Date: 2021-03-11