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Cited by 362Gestational Diabetes Research and ManagementObesity, Physical Activity, DietMaternal and Neonatal Healthcare

Risk of Adverse Pregnancy Outcomes by Prepregnancy Body Mass Index: A Population-Based Study to Inform Prepregnancy Weight Loss Counseling

Open access
Schummers, Laura, Hutcheon, Jennifer A., Bodnar, Lisa M., Lieberman, Ellice, Himes, Katherine P.·2015·Obstetrics & Gynecology
DOI 10.1097/aog.0000000000000591PMC PMC4285688
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Abstract

OBJECTIVE: To estimate the absolute risks of adverse maternal and perinatal outcomes based on small differences in prepregnancy body mass (eg, 10% of body mass or 10-20 pounds). METHODS: This population-based cohort study (N=226,958) was drawn from all singleton pregnancies in British Columbia (Canada) from 2004 to 2012. The relationships between prepregnancy body mass index (BMI) (as a continuous, nonlinear variable) and adverse pregnancy outcomes were examined using logistic regression models. Analyses were adjusted for maternal age, height, parity, and smoking in pregnancy. Adjusted absolute risks of each outcome are reported according to incremental differences in prepregnancy BMI and weight in pounds. RESULTS: A 10% difference in prepregnancy BMI was associated with at least a 10% lower risk of preeclampsia, gestational diabetes, indicated preterm delivery, macrosomia, and stillbirth. In contrast, larger differences in prepregnancy BMI (20-30% differences in BMI) were necessary to meaningfully reduce risks of cesarean delivery, shoulder dystocia, neonatal intensive care unit stay 48 hours or longer, and in-hospital newborn mortality. Prepregnancy BMI was not associated with risk of postpartum hemorrhage requiring intervention, severe maternal morbidity or maternal mortality, or spontaneous preterm delivery before 32 weeks of gestation. CONCLUSION: These results can inform prepregnancy weight loss counseling by defining achievable weight loss goals for patients that may reduce their risk of poor perinatal outcomes. LEVEL OF EVIDENCE: II.

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  • Lifestyle changes, such as reducing alcohol use and smoking, losing weight, improving fruit and vegetable consumption, can reduce the prevalence of adverse pregnancy outcomes, especially when initiated in early pregnancy or even before conception.

    “Evidence suggests that lifestyle changes, such as reducing alcohol use and smoking, losing weight, improving fruit and vegetable consumption, can reduce the prevalence of adverse pregnancy outcomes, especially when initiated in early pregnancy or even before conception [4–7].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [4]

    The Discussion reports that lower prepregnancy BMI was associated with lower risks of several adverse pregnancy outcomes and proposes using the findings for preconception weight-loss counseling. The study was observational, so it does not establish that losing weight causes those reductions. The cited passages do not support the sentence's claims about reducing alcohol use or smoking, increasing fruit and vegetable consumption, or initiating changes in early pregnancy. (LLM, conf=0.88)

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  • A 10% lower preconception BMI is associated with clinically meaningful risk reduction in pre-eclampsia, GDM, preterm birth, macrosomia, and stillbirth.

    “a population-based study showed that a 10 % lower preconception BMI was associated with clinically meaningful risk reduction in pre-eclampsia, GDM, preterm birth, macrosomia, and stillbirth [4].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [4]

    The Discussion reports clinically meaningful risk differences associated with a 10% difference in prepregnancy BMI for preeclampsia, gestational diabetes, indicated preterm delivery, macrosomia, and stillbirth. The claim says “preterm birth” without specifying indicated delivery; the Results report no significant relationship with spontaneous preterm delivery before 32 weeks. Page numbers were not provided in the passages. (LLM, conf=0.90)

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Research works printed but not linked: 2

  1. [28]Frosst GO Joseph KS Hutcheon JA Kinniburgh BA Lee L Validity of data in a population-based perinatal database routinely used for surveillance and research. Proceedings of the 27th Annual Meeting of the Society for Pediatric and Perinatal Epidemiologic Research Seattle, WA. 2014
  2. [29]Harrell FE Regression modeling strategies with applications to linear models, logistic regression, and survival analysis 2001 Springer New York, NY

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Authors
Schummers, L., Hutcheon, J. A., Bodnar, L. M., Lieberman, E., & Himes, K. P.
Affiliations
Brigham and Women's Hospital (US)
ORCID
Venue
Obstetrics & Gynecology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-01
Volume
125
Issue
1
Pages
133-143
ISSN
0029-7844 (ISSN-L)
DOI
10.1097/aog.0000000000000591
PMC
PMC4285688
OpenAlex
W2059013824
Cited by
360
References
35
Citations by year
2026: 16 · 2025: 24 · 2024: 21 · 2023: 33 · 2022: 35 · 2021: 37 · 2020: 34 · 2019: 27 · 2018: 20 · 2017: 74 · 2016: 26 · 2015: 13
FWCI
40.09
Type
journal article
Language
en
Open access
Locations
  • Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD063087, T32HD060454)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
pre-pregnancy body mass index, maternal obesity, adverse pregnancy outcomes, preeclampsia, gestational diabetes mellitus, preterm birth, macrosomia, stillbirth, cesarean section, shoulder dystocia, neonatal intensive care, absolute risk
MeSH terms
Adult, British Columbia, Cesarean Section, Female, Fetal Macrosomia, Humans, Obesity, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Cohort Studies, Weight Loss, Body Mass Index, Preconception Care, Risk Assessment, Directive Counseling, Premature Birth, Stillbirth, Young Adult

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