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Risk of Adverse Pregnancy Outcomes by Prepregnancy Body Mass Index: A Population-Based Study to Inform Prepregnancy Weight Loss Counseling
Open accessAbstract
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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“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]
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“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]
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Metadata
- Authors
- Schummers, L., Hutcheon, J. A., Bodnar, L. M., Lieberman, E., & Himes, K. P.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2015-01
- Volume
- 125
- Issue
- 1
- Pages
- 133-143
- ISSN
- 0029-7844 (ISSN-L)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 › Medicine › Pediatrics, Perinatology and Child Health › 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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