Abstract
Objective: To evaluate the association between pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes using a large administrative database. Methods: Retrospective cohort study of California women delivering singletons in 2007. The association between pre-pregnancy BMI category and adverse outcomes were evaluated using multivariate logistic regression. Results: Among 436,414 women, increasing BMI was associated with increasing odds of adverse outcomes. Obese women (BMI = 30–39.9) were nearly 3x more likely to have gestational diabetes (OR = 2.83, 95% CI = 2.74–2.92) and gestational hypertension/preeclampsia (2.68, 2.59–2.77) and nearly twice as likely to undergo cesarean (1.82, 1.78–1.87), when compared to normal BMI women (BMI = 18.5–24.9). Morbidly obese women (BMI ≥ 40) were 4x more likely to have gestational diabetes (4.72, 4.46–4.99) and gestational hypertension/preeclampsia (4.22, 3.97–4.49) and nearly 3x as likely to undergo cesarean (2.60, 2.46–2.74). Conclusion: There is a strong association between increasing maternal BMI and adverse pregnancy outcomes. This information is important for counseling women regarding the risks of obesity in pregnancy.
Acknowledgement
This research was presented at the 31st Annual Scientific Meeting of the Society for Maternal Fetal Medicine, San Francisco, CA, Feb. 10–12, 2011 and was supported by Title V funds received from the California Department of Public Health; Maternal, Child and Adolescent Health Division. Analysis, interpretation, or conclusions reached are those of the authors and not the state of California.
Declaration of Interest: None of the authors have any conflict of interest to disclose.