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Are early first trimester weights valid proxies for preconception weight?

Rebecca A Krukowski1, Delia S West2, Marisha DiCarlo3

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Summary

First trimester weight accurately estimates preconception body mass index (BMI) category for most pregnant women. Early first trimester weight measurements are particularly effective for determining appropriate gestational weight gain guidelines.

Keywords:
ObesityObstetricsPreventive medicine

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal Health
  • Clinical Nutrition

Background:

  • Accurate preconception weight is crucial for determining appropriate gestational weight gain (GWG) ranges according to Institute of Medicine guidelines.
  • Proximal preconception weight data is often unavailable for most pregnant individuals.
  • This study investigates the utility of early first trimester weight measurements for estimating preconception body mass index (BMI) categories.

Purpose of the Study:

  • To assess the validity of using first trimester weight measurements to estimate preconception BMI categories.
  • To determine the accuracy of early (4-10 weeks) and later (12 weeks) first trimester weights in classifying women's BMI categories.
  • To evaluate the implications of using first trimester weights for assigning GWG guidelines.

Main Methods:

  • A cohort of 43 women had their preconception weight and two first trimester weights (4-10 weeks and 12 weeks gestation) measured under identical conditions.
  • Statistical analysis was performed to compare the accuracy of first trimester weights in classifying preconception BMI categories.

Main Results:

  • First trimester weights at 4-10 weeks and 12 weeks gestation correctly classified 95% and 91% of women's BMI categories, respectively.
  • Mean weight changes in the first trimester were relatively small (0.74 ± 1.99 kg at 4-10 weeks; 1.02 ± 2.46 kg at 12 weeks).
  • Significant differences in mean weight gain were observed between normal weight and overweight/obese participants at 4-10 weeks, but not at 12 weeks.

Conclusions:

  • First trimester weight, especially early in gestation, serves as a reliable proxy for estimating preconception BMI category.
  • Using early first trimester weight for GWG guideline assignment results in minimal misclassification (5-9%) of women.
  • Further modeling strategies may enhance the precision of preconception BMI category estimation from first trimester weights.