We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The Association Between Pre-pregnancy BMI and Preterm Delivery in a Diverse Southern California Population of Working Women.
- Authors
Kosa, Jessica; Guendelman, Sylvia; Pearl, Michelle; Graham, Steve; Abrams, Barbara; Kharrazi, Martin
- Abstract
Whereas preterm birth has consistently been associated with low maternal pre-pregnancy weight, the relationship with high pre-pregnancy weight has been inconsistent. We quantified the pre-pregnancy BMI-preterm delivery (PTD) relationship using traditional BMI categories (underweight, normal weight, overweight and obese) as well as continuous BMI. Eligible women participated in California's statewide prenatal screening program, worked during pregnancy, and delivered a live singleton birth in Southern California in 2002-2003. The final analytic sample included 354 cases delivering at <37 weeks, as identified by clinical estimate of gestational age from screening records, and 710 term normal-birthweight controls. Multivariable logistic regression models using categorical BMI levels and continuous BMI were compared. In categorical analyses, PTD was significantly associated with pre-pregnancy underweight only. Nonparametric local regression revealed a V-shaped relationship between continuous BMI and PTD, with minimum risk at the high end of normal, around 24 kg/m. The odds ratio (OR) for PTD associated with low BMI within the normal range (19 kg/m) was 2.84 (95%CI = 1.61-5.01); ORs for higher BMI in the overweight (29 kg/m) and obese (34 kg/m) ranges were 1.42 (95%CI = 1.10-1.84) and 2.01 (95% CI = 1.20-3.39) respectively, relative to 24 kg/m). BMI categories obscured the preterm delivery risk associated with low-normal, overweight, and obese BMI. We found that higher BMI up to around 24 kg/m is increasingly protective of preterm delivery, beyond which a higher body mass index becomes detrimental. Current NHLBI/WHO BMI categories may be inadequate for identifying women at higher risk for PTD.
- Subjects
CALIFORNIA; RISK factors in premature labor; MALNUTRITION; BIRTH certificates; LOW birth weight; COMPUTER software; CONFIDENCE intervals; DEMOGRAPHY; EPIDEMIOLOGY; GESTATIONAL age; PREMATURE infants; INTERVIEWING; MEDICAL records; MULTIVARIATE analysis; NONPARAMETRIC statistics; OBESITY; REGRESSION analysis; RESEARCH funding; RISK assessment; STATISTICAL sampling; SELF-evaluation; STATISTICS; PSYCHOLOGICAL stress; TELEPHONES; WOMEN employees; LOGISTIC regression analysis; DATA analysis; MULTIPLE regression analysis; SOCIOECONOMIC factors; BODY mass index; CASE-control method
- Publication
Maternal & Child Health Journal, 2011, Vol 15, Issue 6, p772
- ISSN
1092-7875
- Publication type
Article
- DOI
10.1007/s10995-010-0633-4