Association Between Prepregnancy Obesity and Health Behaviors, Adverse Conditions, and Birth Outcomes in South Dakota

Prepregnancy obesity has been shown to be associated with increased risk of adverse birth outcomes but little is known about the associations with health-related behaviors and conditions before, during and after pregnancy.

This retrospective cohort study used data from the South Dakota Pregnancy Risk Assessment Monitoring System (SD PRAMS) survey, which is an ongoing state-based surveillance system of maternal behaviors, attitudes, and experiences before, during, and shortly after pregnancy. The 2017 and 2018 SD PRAMS sampled a total of 3,805 mothers who were randomly selected from birth certificate records to be representative of all South Dakota women who delivered a live-born infant. Logistic regression was used to determine whether prepregnancy obesity was associated with adverse health conditions after controlling for demographic factors.

Women with prepregnancy obesity, compared to those who were non-obese, were more likely to report an unintended pregnancy (45 percent vs. 39 percent), smoking three months before pregnancy (32 percent vs. 22 percent), delayed prenatal care (12 percent vs. 16 percent), hypertension during pregnancy (22 percent vs. 9 percent), gestational diabetes (19 percent vs. 8 percent), depression during pregnancy (21 percent vs. 14 percent), C-section delivery (35 percent vs. 22 percent), high birth weight (15 percent vs. 8 percent), and the infant hospitalized for three or more days (41 percent vs. 30 percent). Of women with prepregnancy obesity, 37 percent had been talked to by health care providers about maintaining a healthy weight the 12 months before pregnancy compared to 13 percent of non-obese women.

Health care workers should be more intentional about stressing the potential risks of prepregnancy obesity to properly educate mothers and women of childbearing age.