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Maternal and Child Health Journal

Erschienen in:

01.10.2013

Class III Obesity and Unwanted Pregnancy Among Women with Live Births in New York City, 2004–2007

verfasst von: Samantha Garbers, Mary Ann Chiasson

Erschienen in: Maternal and Child Health Journal | Ausgabe 8/2013

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Abstract

Obesity is associated with numerous adverse health effects for pregnant women and their newborns. Unintended pregnancy is associated with suboptimal prenatal health behaviors and adverse birth outcomes. While research has suggested a link between obesity and unintended pregnancy, the evidence has been contradictory. Research has not focused on women at the highest level of obesity, Class III (body mass index ≥40). Pregnancy Risk Assessment Monitoring System data for 4,161 women in New York City with a live birth from 2004 to 2007 and complete data on pregnancy intention, height, and weight were examined. The primary outcome, having a live birth that resulted from an unwanted pregnancy (not wanted at that time or at any time in the future), was compared across 6 groups of pre-pregnancy body mass index (BMI). Logistic regression models adjusting for sociodemographic factors and stressors during pregnancy were conducted. The proportion of women reporting their pregnancy was unwanted increased with increasing BMI level to a high of 24 % among women with Class III obesity. After adjustment for confounding sociodemographic factors, women classified as Class III obese were significantly more likely than women with normal BMI to report an unwanted pregnancy [AOR = 2.81 (95 % CI: 1.41–5.60)]; this relationship held after adjusting for stressors during pregnancy. No significant association was found for women of other BMI groups. Previous analyses may have masked a relationship between BMI and unwanted pregnancy among women with Class III obesity. Further research exploring underlying mechanisms which are amenable to intervention is of critical public health importance.

Flegal, K. M., Carroll, M. D., Kit, B. K., & Ogden, C. L. (2012). Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA, 307, 491–497.CrossRefPubMed

Kulie, T., Slattengren, A., Redmer, J., Counts, H., Eglash, A., & Schrager, S. (2011). Obesity and women’s health: An evidence-based review. Journal of the American Board of Family Medicine, 24, 75–85.CrossRefPubMed

Norman, J. E. (2010). The adverse effects of obesity on reproduction. Reproduction, 140, 343–345.CrossRefPubMed

Rosenberg, T. J., Garbers, S., Lipkind, H., & Chiasson, M. A. (2005). Maternal obesity and diabetes as risk factors for adverse pregnancy outcomes: Differences among 4 racial/ethnic groups. American Journal of Public Health, 95, 1545–1551.CrossRefPubMed

Rosenberg, T. J., Garbers, S., Chavkin, W., & Chiasson, M. A. (2003). Prepregnancy weight and adverse perinatal outcomes in an ethnically diverse population. Obstetrics and Gynecology, 102, 1022–1027.CrossRefPubMed

King, J. C. (2006). Maternal obesity, metabolism, and pregnancy outcomes. Annual Review of Nutrition, 26, 271–291.CrossRefPubMed

Catalano, P. M. (2010). Obesity, insulin resistance, and pregnancy outcome. Reproduction, 140, 365–371.CrossRefPubMed

Weiss, J. L., Malone, F. D., Emig, D., Ball, R. H., Nyberg, D. A., Comstock, C. H., et al. (2004). Obesity, obstetric complications and cesarean delivery rate–a population-based screening study. American Journal of Obstetrics and Gynecology, 190, 1091–1097.CrossRefPubMed

Finer, L. B., & Henshaw, S. K. (2006). Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspectives on Sexual and Reproductive Health, 38, 90–96.CrossRefPubMed

10.

Finer, L. B., & Kost, K. (2011). Unintended pregnancy rates at the state level. Perspectives on Sexual and Reproductive Health, 43, 78–87.CrossRefPubMed

11.

Finer, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: Incidence and disparities, 2006. Contraception, 84, 478–485.CrossRefPubMed

12.

Santelli, J., Rochat, R., Hatfield-Timajchy, K., Gilbert, B. C., Curtis, K., Cabral, R., et al. (2003). The measurement and meaning of unintended pregnancy. Perspectives on Sexual and Reproductive Health, 35, 94–101.CrossRefPubMed

13.

Gipson, J. D., Koenig, M. A., & Hindin, M. J. (2008). The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Studies in Family Planning, 39, 18–38.CrossRefPubMed

14.

Logan, C., Holcombe, E., Manolve, J., & Ryan, S. (2007). The consequences of unintended childbearing: A white paper. Washington: Child Trends, Inc.

15.

Pulley, L., Klerman, L. V., Tang, H., & Baker, B. A. (2002). The extent of pregnancy mistiming and its association with maternal characteristics and behaviors and pregnancy outcomes. Perspectives on Sexual and Reproductive Health, 34, 206–211.CrossRefPubMed

16.

Shah, P. S., Balkhair, T., Ohlsson, A., Beyene, J., Scott, F., & Frick, C. (2011). Intention to become pregnant and low birth weight and preterm birth: A systematic review. Maternal and Child Health Journal, 15, 205–216.CrossRefPubMed

17.

Dye, T. D., Wojtowycz, M. A., Aubry, R. H., Quade, J., & Kilburn, H. (1997). Unintended pregnancy and breast-feeding behavior. American Journal of Public Health, 87, 1709–1711.CrossRefPubMed

18.

D’Angelo, D. V., Gilbert, B. C., Rochat, R. W., Santelli, J. S., & Herold, J. M. (2004). Differences between mistimed and unwanted pregnancies among women who have live births. Perspectives on Sexual and Reproductive Health, 36, 192–197.CrossRefPubMed

19.

Cheng, D., Schwarz, E. B., Douglas, E., & Horon, I. (2009). Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception, 79, 194–198.CrossRefPubMed

20.

Brunner, L. R., & Hogue, C. J. (2005). The role of body weight in oral contraceptive failure: Results from the 1995 national survey of family growth. Annals of Epidemiology, 15, 492–499.CrossRefPubMed

21.

Kaneshiro, B., Edelman, A., Carlson, N., Nichols, M., & Jensen, J. (2008). The relationship between body mass index and unintended pregnancy: Results from the 2002 National Survey of Family Growth. Contraception, 77, 234–238.CrossRefPubMed

22.

Gipson, J. D., & Santelli, J. S. (2011). Unplanned and assisted conception pregnancies. BMJ, 343, d4996.CrossRefPubMed

23.

Santelli, J. S., Lindberg, L. D., Orr, M. G., Finer, L. B., & Speizer, I. (2009). Toward a multidimensional measure of pregnancy intentions: Evidence from the United States. Studies in Family Planning, 40, 87–100.CrossRefPubMed

24.

Speizer, I. S., Santelli, J. S., Afable-Munsuz, A., & Kendall, C. (2004). Measuring factors underlying intendedness of women’s first and later pregnancies. Perspectives on Sexual and Reproductive Health, 36, 198–205.CrossRefPubMed

25.

Sable, M. R. (1999). Pregnancy intentions may not be a useful measure for research on maternal and child health outcomes. Family Planning Perspectives, 31, 249–250.CrossRefPubMed

26.

Klerman, L. V. (2000). The intendedness of pregnancy: A concept in transition. Maternal and Child Health Journal, 4, 155–162.CrossRefPubMed

27.

Hayford, S. R., Wildsmith, E., & Guzzo, K. B. (2009). Measurement problems in assessing trends in unwanted fertility. Journal of Adolescent Health, 45, 105. (author reply-6).CrossRefPubMed

28.

Huber, L. R., Hogue, C. J., Stein, A. D., Drews, C., Zieman, M., King, J., et al. (2006). Contraceptive use and discontinuation: Findings from the contraceptive history, initiation, and choice study. American Journal of Obstetrics and Gynecology, 194, 1290–1295.CrossRefPubMed

29.

Vahratian, A., Barber, J. S., Lawrence, J. M., & Kim, C. (2009). Family-planning practices among women with diabetes and overweight and obese women in the 2002 National Survey For Family Growth. Diabetes Care, 32, 1026–1031.CrossRefPubMed

30.

Dinger, J. C., Cronin, M., Mohner, S., Schellschmidt, I., Minh, T. D., & Westhoff, C. (2009). Oral contraceptive effectiveness according to body mass index, weight, age, and other factors. American Journal of Obstetrics and Gynecology, 201(263), e1–e9.PubMed

31.

Lash, M. M., & Armstrong, A. (2009). Impact of obesity on women’s health. Fertility and Sterility, 91, 1712–1716.CrossRefPubMed

32.

Holt, V. L., Cushing-Haugen, K. L., & Daling, J. R. (2002). Body weight and risk of oral contraceptive failure. Obstetrics and Gynecology, 99, 820–827.CrossRefPubMed

33.

Holt, V. L., Scholes, D., Wicklund, K. G., Cushing-Haugen, K. L., & Daling, J. R. (2005). Body mass index, weight, and oral contraceptive failure risk. Obstetrics and Gynecology, 105, 46–52.CrossRefPubMed

34.

Lopez, L. M., Grimes, D. A., Chen-Mok, M., Westhoff, C., Edelman, A., & Helmerhorst, F. M. (2010). Hormonal contraceptives for contraception in overweight or obese women. Cochrane Database Systematic Review, 7, CD008452.

35.

Murthy, A. S. (2010). Obesity and contraception: Emerging issues. Seminars in Reproductive Medicine, 28, 156–163.CrossRefPubMed

36.

Trussell, J., Schwarz, E. B., & Guthrie, K. (2009). Obesity and oral contraceptive pill failure. Contraception, 79, 334–338.CrossRefPubMed

37.

Dinger, J., Minh, T. D., Buttmann, N., & Bardenheuer, K. (2011). Effectiveness of oral contraceptive pills in a large U.S. cohort comparing progestogen and regimen. Obstetrics and Gynecology, 117, 33–40.CrossRefPubMed

38.

PRAMS Methodology. Atlanta, GA: Centers for Disease Control and Prevention. http://www.cdc.gov/prams/methodology.htm. Accessed 26 Sep 2012.

39.

NHLBI Obesity Education Initiative. (2000). The practical guide: Identification, evaluation, and treatment of overweight and obesity in adults. Bethesda, MD: National Heart, Lung and Blood Institute.

40.

Ball, K., Mishra, G., & Crawford, D. (2002). Which aspects of socioeconomic status are related to obesity among men and women? International Journal of Obesity and Related Metabolic Disorders, 26, 559–565.CrossRefPubMed

41.

James, S. A., Fowler-Brown, A., Raghunathan, T. E., & Van Hoewyk, J. (2006). Life-course socioeconomic position and obesity in African American Women: The Pitt County Study. American Journal of Public Health, 96, 554–560.CrossRefPubMed

42.

Sobal, J. (1991). Obesity and socioeconomic status: A framework for examining relationships between physical and social variables. Medical Anthropology, 13, 231–247.CrossRefPubMed

43.

Cubbin, C., Braveman, P. A., Marchi, K. S., Chavez, G. F., Santelli, J. S., & Gilbert, B. J. (2002). Socioeconomic and racial/ethnic disparities in unintended pregnancy among postpartum women in California. Maternal and Child Health Journal, 6, 237–246.CrossRefPubMed

44.

Dehlendorf, C., Rodriguez, M. I., Levy, K., Borrero, S., & Steinauer, J. (2010). Disparities in family planning. American Journal of Obstetrics and Gynecology, 202, 214–220.CrossRefPubMed

45.

Brunner Huber, L. R., & Hogue, C. J. (2005). The association between body weight, unintended pregnancy resulting in a livebirth, and contraception at the time of conception. Maternal and Child Health Journal, 9, 413–420.CrossRefPubMed

46.

Williams, L., Piccinino, L., Abma, J., & Arguillas, F. (2001). Pregnancy wantedness: Attitude stability over time. Social Biology, 48, 212–233.PubMed

47.

Poole, V. L., Flowers, J. S., Goldenberg, R. L., Cliver, S. P., & McNeal, S. (2000). Changes in intendedness during pregnancy in a high-risk multiparous population. Maternal and Child Health Journal, 4, 179–182.CrossRefPubMed

48.

Craig, B. M., & Adams, A. K. (2009). Accuracy of body mass index categories based on self-reported height and weight among women in the United States. Maternal and Child Health Journal, 13, 489–496.CrossRefPubMed

49.

Brunner Huber, L. R. (2007). Validity of self-reported height and weight in women of reproductive age. Maternal and Child Health Journal, 1, 137–144.CrossRef

50.

Jungheim, E. S., & Moley, K. H. (2010). Current knowledge of obesity’s effects in the pre- and periconceptional periods and avenues for future research. American Journal of Obstetrics and Gynecology, 203, 525–530.CrossRefPubMed

51.

Chuang, C. H., Chase, G. A., Bensyl, D. M., & Weisman, C. S. (2005). Contraceptive use by diabetic and obese women. Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health, 15, 167–173.CrossRef

52.

Chin, J. R., Swamy, G. K., Ostbye, T., & Bastian, L. A. (2009). Contraceptive use by obese women 1 year postpartum. Contraception, 80, 463–468.CrossRefPubMed

53.

Schraudenbach, A., & McFall, S. (2009). Contraceptive use and contraception type in women by body mass index category. Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health, 19, 381–389.CrossRef

54.

Williams, S. L., Kavanaugh, M. L., Parisi, S. M., Borrero, S., & Schwarz, E. B. (2011). Contraceptive use among obese women: Results from the 2006–2008 National Survey of Family Growth. Contraception, 84, 329.CrossRef

55.

Scott-Ram, R., Chor, J., Bhogireddy, V., Keith, L., & Patel, A. (2012). Contraceptive choices of overweight and obese women in a publically funded hospital: Possible clinical implications. Contraception, 86, 122–126.

56.

Westhoff, C. L., Torgal, A. T., Mayeda, E. R., Shimoni, N., Stanczyk, F. Z., & Pike, M. C. (2011). Predictors of noncompliance in an oral contraceptive clinical trial. Contraception, 85, 465–469.

57.

Erbil, N. (2012). The relationships between sexual function, body image, and body mass index among women. Sexuality and Disability (In press).

58.

Christensen, B. S., Gronbaek, M., Pedersen, B. V., Graugaard, C., & Frisch, M. (2011). Associations of unhealthy lifestyle factors with sexual inactivity and sexual dysfunctions in Denmark. Journal of Sexual Medicine, 8, 1903–1916.CrossRefPubMed

59.

Bajos, N., Wellings, K., Laborde, C., & Moreau, C. (2010). Sexuality and obesity, a gender perspective: Results from French national random probability survey of sexual behaviours. BMJ, 340, c2573.CrossRefPubMed

60.

Kershaw, T. S., Arnold, A., Lewis, J. B., Magriples, U., & Ickovics, J. R. (2011). The skinny on sexual risk: The effects of BMI on STI incidence and risk. AIDS and Behavior, 15, 1527–1538.CrossRefPubMed

61.

Cedergren, M. I. (2004). Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstetrics and Gynecology, 103, 219–224.CrossRefPubMed

62.

Bodnar, L. M., Siega-Riz, A. M., Simhan, H. N., Himes, K. P., & Abrams, B. (2010). Severe obesity, gestational weight gain, and adverse birth outcomes. American Journal of Clinical Nutrition, 91, 1642–1648.CrossRefPubMed

63.

Rodriguez, M. I., & Edelman, A. B. (2011). Safety and efficacy of contraception–Why should the obese woman be any different? Reviews in Endocrine & Metabolic Disorders, 12, 85–91.CrossRef

64.

Teal, S. B., Ginosar, & D. M. (2007). Contraception for women with chronic medical conditions. Obstetrics and Gynecology Clinics of North America, 34:113–126, ix.

Titel: Class III Obesity and Unwanted Pregnancy Among Women with Live Births in New York City, 2004–2007
verfasst von: Samantha Garbers
Mary Ann Chiasson
Publikationsdatum: 01.10.2013
Verlag: Springer US
Erschienen in: Maternal and Child Health Journal / Ausgabe 8/2013
Print ISSN: 1092-7875
Elektronische ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-012-1150-4

Springer Medizin

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