Obstetric outcomes associated with increase in BMI category during pregnancy

doi:10.1016/j.ajog.2004.06.051

American Journal of Obstetrics and Gynecology

Volume 191, Issue 3, September 2004, Pages 928-932

https://doi.org/10.1016/j.ajog.2004.06.051 Get rights and content

Objective

The purpose of this study was to investigate effect of increase in body mass index (BMI) category on obstetric outcomes.

Study design

A cohort study was conducted from 1999 to 2002. Women with singleton pregnancies were placed in standard BMI categories. Increase in BMI was calculated as difference between initial BMI and delivery BMI. ANOVA was used to compare continuous variables, and chi-square test for categorical variables.

Results

This study included 5131 women: 49.8% had no change in BMI category, 43.9% increased by 1 BMI category, and 6.3% by >1 category. Increase in BMI category was associated with higher rates of gestational diabetes (P = .005), failed induction (P < .001), lacerations (P < .001), cesarean deliveries (P < .001), and postpartum infection (P = .007) in normal weight women. Overweight women also had increased rates of preeclampsia (P = .002) and operative vaginal deliveries (P < .001). Obese women had higher rates of chorioamnionitis (P = .003), failed induction (P < .001), and cesarean deliveries (P = .016).

Conclusion

Increase in BMI category is associated with increased risk of complications.

Section snippets

Material and methods

The obstetric database at Grady Memorial Hospital contains prospectively collected data on all pregnant women admitted to the hospital using standard data collection sheets. Institutional Review Board approved this study. Women with singleton pregnancies who delivered between 1999 and 2002 were included in the study. Women with multiple pregnancies and with a BMI <20 were excluded from this study. Underweight (BMI <20) has been shown to be associated with increased risk of preterm delivery, low

Results

Ten thousand eight hundred and eighty singleton pregnancies were identified in the Grady Memorial Hospital database. Distribution of women in the study based on BMI categories at first prenatal visit is illustrated in Figure 1. Women with incomplete BMI data (49.2%) were compared with women with complete BMI data (50.8%). Missing BMI was often the consequence of missing height, or care outside the institution-based prenatal clinics. There were no significant differences in demographic and

Comment

Obesity is a growing problem in this country, and it may have an important impact on pregnancy complications. To our knowledge, this is the first study to investigate pregnancy weight gain in terms of change in BMI categories and perinatal complications. During data collection, it was noted that a large proportion of the women in the database (49.2%) did not have BMI at initial visit and at delivery recorded. These omissions most often reflect unrecorded heights, prenatal care outside the scope

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: Presented at the Twenty-Fourth Annual Meeting of the Society for Maternal-Fetal Medicine, February 2-7, 2004, New Orleans, La.

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Transactions of the Twenty-Fourth Annual Meeting of the Society for Maternal-Fetal MedicineObstetric outcomes associated with increase in BMI category during pregnancy

Objective

Study design

Results

Conclusion

Section snippets

Material and methods

Results

Comment

Obstet Gynecol

Obstet Gynecol

Am J Obstet Gynecol

Obstet Gynecol

Obstet Gynecol

BJOG

Am J Obstet Gynecol

Transactions of the Twenty-Fourth Annual Meeting of the Society for Maternal-Fetal Medicine
Obstetric outcomes associated with increase in BMI category during pregnancy