The Association between Prepregnancy Maternal Body Mass Index and Preterm Delivery

Yan Zhong; Alison G Cahill; George A Macones; Fufan Zhu; Anthony O Odibo

doi:10.1055/s-0029-1241736

American Journal of Perinatology, Table of Contents

Am J Perinatol 2010; 27(4): 293-298
DOI: 10.1055/s-0029-1241736

The Association between Prepregnancy Maternal Body Mass Index and Preterm Delivery

Yan Zhong¹ ^, ² , Alison G. Cahill¹ , George A. Macones¹ , Fufan Zhu² , Anthony O. Odibo¹

¹Departments of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University in St. Louis, St. Louis, Missouri
²Departments of Obstetrics and Gynecology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China

Abstract

ABSTRACT

We investigated the association between prepregnancy maternal body mass index (BMI) and preterm delivery (PTD). The study included 44,421 American women presenting for care in Saint Louis, Missouri between 1990 and 2006. Only singleton gestations were included. The authors examined the associations between categories of BMI with PTD <37 and <34 weeks, respectively. A stratified analysis by subtypes of PTD was also performed. The subtypes of PTD evaluated included spontaneous PTD without preterm premature rupture of membranes (PPROM), PPROM, and indicated PTD. Univariate and multivariable analyses were used to estimate the association between maternal BMI categories and PTD <37 weeks, PTD <34 weeks, and subtypes of PTD. Among women meeting the inclusion criteria, PTD <37 occurred in 4783 (10.8%) and PTD <34 weeks in 1132 (2.5%). Being underweight was associated with increased risks of PTD <37 weeks (adjusted odd ratio [OR] = 1.3, 95% confidence interval [CI]: 1.2, 1.5). Being obese was associated with decreased risks of spontaneous PTD without PPROM <37 weeks (adjusted OR = 0.8, 95% CI: 0.7, 0.9) and increased risk of PPROM <37 weeks (adjusted OR = 1.3, 95% CI: 1.1, 1.6) and PPROM <34 weeks (adjusted OR = 1.4, 95% CI: 1.0, 2.0). Prepregnancy obesity increases the risk of PPROM and decreases risk of spontaneous PTD without PPROM.

KEYWORDS

Body mass index - preterm birth - subtypes of preterm birth

Full Text

References

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Anthony O OdiboM.D. M.S.C.E.

Department of Obstetrics and Gynecology, Division of MFM and Ultrasound, Washington University Medical Center

4990 Children's Place, Suite 1130, St. Louis, MO 63110

Email: odiboa@wudosis.wustl.edu