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Prepregnancy body mass index and risk of preterm birth: association heterogeneity by preterm subgroups

Margaret G Parker1, Fengxiu Ouyang, Colleen Pearson

  • 1Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, USA. margaret.parker@bmc.org.

BMC Pregnancy and Childbirth
|May 1, 2014
PubMed

Insights

Prepregnancy obesity increases the risk of medically-induced preterm birth (PTB), but not spontaneous PTB. Pregnancy complications like hypertensive disorders and gestational diabetes partially mediate this association.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Public Health

Background:

  • Prepregnancy body mass index (BMI) is a critical factor in pregnancy outcomes.
  • Understanding the differential impact of prepregnancy BMI on various preterm birth (PTB) subtypes is essential.

Purpose of the Study:

  • To investigate the association between prepregnancy BMI and subtypes of preterm birth (PTB): early vs. late and medically-induced vs. spontaneous.
  • To explore potential mediation by pregnancy complications such as hypertensive disorders, chorioamnionitis, and gestational diabetes.

Main Methods:

  • Utilized data from the Boston Birth Cohort.
  • Employed multinomial regression to analyze associations between prepregnancy BMI and PTB subtypes versus term births.
  • Conducted sequential models to assess mediation by pregnancy complications.

Main Results:

  • Prepregnancy obesity (BMI ≥ 30.0 kg/m²) was more prevalent in mothers with medically-induced PTBs.
  • Obesity was linked to increased odds of both early and late medically-induced PTB, with associations attenuated by hypertensive disorders and gestational diabetes.
  • Conversely, prepregnancy obesity showed decreased odds of spontaneous PTB, while underweight was nearly associated with increased odds.

Conclusions:

  • Prepregnancy obesity is a significant risk factor for medically-induced preterm birth (PTB), but not spontaneous PTB.
  • Hypertensive disorders of pregnancy and gestational diabetes partially mediate the relationship between prepregnancy obesity and medically-induced PTB.
  • These findings highlight the importance of prepregnancy weight management in mitigating risks for specific PTB pathways.
Abstract

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