Low pre-pregnancy body mass index and risk of medically indicated versus spontaneous preterm singleton birth

Abstract Objective(s) There were three primary objectives of this study: (1) to estimate the risk of preterm and very preterm birth by severity of low pre-pregnancy body mass index (BMI), (2) to determine if the risk in preterm and very preterm birth by severity of low pre-pregnancy BMI differs for...

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Bibliographic Details
Published in:European journal of obstetrics & gynecology and reproductive biology 2009-06, Vol.144 (2), p.119-123
Main Authors: Salihu, H.M, Mbah, A.K, Alio, A.P, Clayton, H.B, Lynch, O
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
BMI
Body Mass Index
Delivery, Obstetric
Diseases of mother, fetus and pregnancy
Female
Gestational weight gain
Gynecology. Andrology. Obstetrics
Humans
Infant, Newborn
Infant, Premature
Medical sciences
Missouri - epidemiology
Nutrition
Obstetrics and Gynecology
Pregnancy
Pregnancy. Fetus. Placenta
Premature Birth - epidemiology
Preterm birth
Retrospective Studies
Thinness
Weight Gain
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Summary:Abstract Objective(s) There were three primary objectives of this study: (1) to estimate the risk of preterm and very preterm birth by severity of low pre-pregnancy body mass index (BMI), (2) to determine if the risk in preterm and very preterm birth by severity of low pre-pregnancy BMI differs for spontaneous versus medically indicated preterm delivery, and finally (3) to determine if there is a difference in the risk for preterm and very preterm birth by severity of low pre-pregnancy BMI across gradations of gestational weight gain. Study design This study utilized the Missouri maternally linked cohort files from 1989 to 1997. After restricting analyses to singleton live births (gestational age 20–44 weeks) and women with either a low or normal BMI, the final study population consisted of 437,403 births. Pre-pregnancy BMI was categorized as normal (19.5–24.9), mild thinness (17.0–18.5), moderate thinness (16.0–16.9) and severe thinness (≤15.9). Statistical analyses included chi-square tests and logistic regression with generalized estimating equations (GEE). Results Underweight mothers were more likely to experience a preterm delivery. For all preterm births, the risk among underweight mothers increased with ascending underweight severity ( p < 0.01). Higher risk estimates were observed for spontaneous than for medically indicated preterm birth. For each BMI category, extreme risk values for spontaneous preterm births were observed among women with very low gestational weight gain (
ISSN:0301-2115
1872-7654
DOI:10.1016/j.ejogrb.2009.02.047