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

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

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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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Authors: Schummers, L., Hutcheon, J. A., Bodnar, L. M., Lieberman, E., & Himes, K. P.
Affiliations: Brigham and Women's Hospital (US)
ORCID: Schummers, Laura
Hutcheon, Jennifer A.
Bodnar, Lisa M.
Himes, Katherine P.
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: 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

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

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