Am J Perinatol 2011; 28(1): 067-074
DOI: 10.1055/s-0030-1262905
© Thieme Medical Publishers

Changes in Prepregnancy Body Mass Index between Pregnancies and Risk of Preterm Phenotypes

Valerie E. Whiteman1 , Kiran Rao1 , Jingyi Duan2 , Amina Alio3 , Phillip J. Marty3 , 4 , Hamisu M. Salihu1 , 2 , 4
  • 1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida, Tampa, Florida
  • 2Department of Epidemiology and Biostatistics, University of South Florida, Tampa, Florida
  • 3Department of Community and Family Health, University of South Florida, Tampa, Florida
  • 4Center for Research and Evaluation, The Chiles Center, University of South Florida, Tampa, Florida
Further Information

Publication History

Publication Date:
16 July 2010 (online)

ABSTRACT

We examined whether the risk of preterm birth and its subtypes (medically indicated and spontaneous preterm) are influenced by changes in prepregnancy body mass index (BMI) between the first and second pregnancies. A population-based, retrospective cohort analysis was performed using the Missouri (1978 to 2005) longitudinally linked cohort data sets. Women with their first two successive singleton live births (n = 436,502) were analyzed. The risks for preterm birth and its subtypes were evaluated using multivariate logistic regression modeling. Compared with women who maintained normal interpregnancy BMI, women who lowered their weight from normal to underweight were more likely to experience preterm and spontaneous preterm birth (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.4 to 1.6). Women with BMI changes from normal weight to obese (OR 1.4, 95% CI 1.2 to 1.6) and normal weight to overweight (OR 1.2, 95% CI 1.1 to 1.3) were at increased risk of medically indicated preterm birth. A decrease in prepregnancy BMI from normal to underweight is associated with increased risk of spontaneous preterm birth, and prepregnancy BMI increases from normal to overweight or to obese BMI are associated with increased risk of medically indicated preterm birth.

REFERENCES

  • 1 World Health Organization Global Strategy on Diet .Physical Activity and Health 2003. Obesity and Overweight. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/index.html Accessed October 11, 1009
  • 2 Hedley A A, Ogden C L, Johnson C L, Carroll M D, Curtin L R, Flegal K M. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002.  JAMA. 2004;  291 2847-2850
  • 3 Flegal K M, Carroll M D, Kuczmarski R J, Johnson C L. Overweight and obesity in the United States: prevalence and trends, 1960–1994.  Int J Obes Relat Metab Disord. 1998;  22 39-47
  • 4 Abrams B F, Laros Jr R K. Prepregnancy weight, weight gain, and birth weight.  Am J Obstet Gynecol. 1986;  154 503-509
  • 5 Naeye R L. Maternal body weight and pregnancy outcome.  Am J Clin Nutr. 1990;  52 273-279
  • 6 Cedergren M I. Maternal morbid obesity and the risk of adverse pregnancy outcome.  Obstet Gynecol. 2004;  103 219-224
  • 7 Yogev Y, Catalano P M. Pregnancy and obesity.  Obstet Gynecol Clin North Am. 2009;  36 285-300, viii
  • 8 Leddy M A, Power M L, Schulkin J. The impact of maternal obesity on maternal and fetal health.  Rev Obstet Gynecol. 2008;  1 170-178
  • 9 Bhattacharya S, Campbell D M, Liston W A, Bhattacharya S. Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies.  BMC Public Health. 2007;  7 168
  • 10 Salihu H M, Alio A P, Wilson R E, Sharma P P, Kirby R S, Alexander G R. Obesity and extreme obesity: new insights into the black-white disparity in neonatal mortality.  Obstet Gynecol. 2008;  111 1410-1416
  • 11 Salihu H M, Lynch O, Alio A P, Liu J. Obesity subtypes and risk of spontaneous versus medically indicated preterm births in singletons and twins.  Am J Epidemiol. 2008;  168 13-20
  • 12 Salihu H M, Dunlop A L, Hedayatzadeh M, Alio A P, Kirby R S, Alexander G R. Extreme obesity and risk of stillbirth among black and white gravidas.  Obstet Gynecol. 2007;  110 552-557
  • 13 Martin J A, Hamilton B E, Sutton P D Centers for Disease Control and Prevention National Center for Health Statistics National Vital Statistics System et al. Births: final data for 2005.  Natl Vital Stat Rep. 2007;  56 1-103
  • 14 Callaghan W M, MacDorman M F, Rasmussen S A, Qin C, Lackritz E M. The contribution of preterm birth to infant mortality rates in the United States.  Pediatrics. 2006;  118 1566-1573
  • 15 Maggard M A, Yermilov I, Li Z et al.. Pregnancy and fertility following bariatric surgery: a systematic review.  JAMA. 2008;  300 2286-2296
  • 16 Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study.  Lancet. 2006;  368 1164-1170
  • 17 Herman A A, McCarthy B J, Bakewell J M et al.. Data linkage methods used in maternally-linked birth and infant death surveillance data sets from the United States (Georgia, Missouri, Utah and Washington State), Israel, Norway, Scotland and Western Australia.  Paediatr Perinat Epidemiol. 1997;  11 (Suppl 1) 5-22
  • 18 Martin J, Curtin S, Saulnier M, Mousavi J. Development of the matched multiple birth file. In: 1995–1998 Matched Multiple Birth Dataset. NCHS CD-ROM series 21, No. 13a Hyattsville, MD: National Center for Health Statistics; 2003
  • 19 Herman A A, Yu K F. Adolescent age at first pregnancy and subsequent obesity.  Paediatr Perinat Epidemiol. 1997;  11 (Suppl 1) 130-141
  • 20 Parker J D, Abrams B. Prenatal weight gain advice: an examination of the recent prenatal weight gain recommendations of the Institute of Medicine.  Obstet Gynecol. 1992;  79 (5 Pt 1) 664-669
  • 21 Ananth C V, Getahun D, Peltier M R, Salihu H M, Vintzileos A M. Recurrence of spontaneous versus medically indicated preterm birth.  Am J Obstet Gynecol. 2006;  195 643-650
  • 22 Taffel S, Johnson D, Heuser R. A method of imputing length of gestation on birth certificates.  Vital Health Stat 2. 1982;  May (93) 1-11
  • 23 Piper J M, Mitchel Jr E F, Snowden M, Hall C, Adams M, Taylor P. Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records.  Am J Epidemiol. 1993;  137 758-768
  • 24 Wingate M S, Alexander G R, Buekens P, Vahratian A. Comparison of gestational age classifications: date of last menstrual period vs. clinical estimate.  Ann Epidemiol. 2007;  17 425-430
  • 25 Alexander G R, Kotelchuck M. Quantifying the adequacy of prenatal care: a comparison of indices.  Public Health Rep. 1996;  111 408-418 discussion 419
  • 26 Alexander G R, Cornely D A. Prenatal care utilization: its measurement and relationship to pregnancy outcome.  Am J Prev Med. 1987;  3 243-253
  • 27 Clayton D, Hills M. Statistical Models in Epidemiology. Oxford: Oxford University Press; 1993: 256-270
  • 28 Smith G C, Shah I, Pell J P, Crossley J A, Dobbie R. Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: a retrospective cohort study.  Am J Public Health. 2007;  97 157-162
  • 29 Hendler I, Goldenberg R L, Mercer B M et al.. The Preterm Prediction Study: association between maternal body mass index and spontaneous and indicated preterm birth.  Am J Obstet Gynecol. 2005;  192 882-886
  • 30 Salihu H M, Lynch O, Alio A P, Liu J. Obesity subtypes and risk of spontaneous versus medically indicated preterm births in singletons and twins.  Am J Epidemiol. 2008;  168 13-20
  • 31 Aly H, Hammad T, Nada A, Mohamed M, Bathgate S, El-Mohandes A. Maternal obesity, associated complications and risk of prematurity.  J Perinatol. 2009;  August 20 (Epub ahead of print)
  • 32 Johnson T S, Rottier K J, Luellwitz A, Kirby R S. Maternal prepregnancy body mass index and delivery of a preterm infant in Missouri 1998–2000.  Public Health Nurs. 2009;  26 3-13
  • 33 Torloni M R, Betrán A P, Daher S et al.. Maternal BMI and preterm birth: a systematic review of the literature with meta-analysis.  J Matern Fetal Neonatal Med. 2009;  22 957-970
  • 34 Salihu H M, Luke S, Alio A P, Deutsch A, Marty P J. The impact of obesity on spontaneous and medically indicated preterm birth among adolescent mothers.  Arch Gynecol Obstet. 2009;  August 26 (Epub ahead of print)

Hamisu M SalihuM.D. Ph.D. 

Professor of Epidemiology, Obstetrics & Gynecology

Director, Center for Research and Evaluation; Lawton and Rhea Chiles Center for Healthy Mothers and Babies, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL 33613

Email: hamisu.salihu@gmail.com