Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes

Mollie McDonnold; Lisa M. Mele; Leslie Myatt; John C. Hauth; Kenneth J. Leveno; Uma M. Reddy; Brian M. Mercer; for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units (MFMU) Network

doi:10.1055/s-0035-1569986

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2016; 33(06): 618-624
DOI: 10.1055/s-0035-1569986

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes

Mollie McDonnold

¹Department of Obstetrics and Gynecology, University of Texas Medical Center, Galveston, Texas

,

Lisa M. Mele

²Biostatistics Center, The George Washington University, Washington, District of Columbia

,

Leslie Myatt

³Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio

,

John C. Hauth

⁴Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama

,

Kenneth J. Leveno

⁵ Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas

,

Uma M. Reddy

⁶The Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland

,

Brian M. Mercer

⁷Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio

,

for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units (MFMU) Network

› Institutsangaben

Abstract

Objective In nonpregnant populations the waist-to-hip ratio (WHR) is a better predictor of obesity-related outcomes than body mass index (BMI). Our objective was to determine, in pregnancy, the relationship between these measures of obesity, and large-for-gestational age (LGA) and cesarean delivery (CD).

Methods This is a secondary analysis of data from the Combined Antioxidant and Preeclampsia Prediction Study. Women with a WHR of ≥ 0.85 and 0.80 to 0.84 at 9 to 16 weeks gestation were compared with those with a WHR < 0.80. Women with early pregnancy BMI ≥ 30.0 kg/m² (obese) and 25.0 to 29.9 kg/m² (overweight) were compared with those < 25.0 kg/m². LGA was defined as > 90% by Alexander nomogram. Univariable analysis, logistic regression, and receiver operating characteristic curves were used.

Results Data from 2,276 women were analyzed. After correcting for potential confounders, only BMI ≥ 30 was significantly associated with LGA (adjusted odds ratio [aOR]: 2.07, 1.35–3.16) while BMI 25.0–29.9 (aOR: 1.5, 0.98–2.28), WHR 0.8–0.84 (aOR: 1.33, 0.83–2.13), and WHR ≥ 0.85 (aOR: 1.05, 0.67–1.65) were not. Risk for CD was increased for women with elevated WHR and with higher BMI compared with normal.

Conclusion WHR is not associated with LGA. While BMI performed better than WHR, neither was a strong predictor of LGA or need for CD in low-risk nulliparous women.

Keywords

obesity - waist-to-hip ratio - cesarean delivery - large-for-gestational age

Volltext

Referenzen

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