title: The effects of obesity and weight gain in young women on obstetric outcomes.
abstract: We investigated body mass index (BMI) and weight gain among pregnant women (ages 14 to 25) and assessed the relationship of BMI and weight gain on birth outcomes. We performed a secondary analysis of 841 women enrolled in a randomized controlled trial receiving prenatal care in two university-affiliated clinics. Almost half the patients were overweight or obese. An average of 32.3 +/- 23.6 pounds was gained in pregnancy with only 25.3% gaining the recommended weight and over half overgaining. Weight gain had a significant relationship to birth weight. Multivariate analysis showed that prepregnancy BMI but not weight gain was a significant predictor of cesarean delivery (odds ratio [OR] 1.91, confidence interval [CI] 1.24 to 2.69, P < 0.0001). When large-for-gestational-age infants were removed from the analysis, there was still a significant effect of BMI on cesarean delivery (OR 1.76, CI 1.17 to 2.66, P = 0.007) but not of weight gain (OR 1.45, CI 0.94 to 2.17, P = 0.093). Prepregnancy BMI is a more significant predictor of cesarean delivery than pregnancy weight gain in young women.
authors.affiliation: Yale University School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, New Haven, Connecticut 06520-8034, USA. urania.magriples@yale.edu
authors.forename: Urania
authors.initials: U
authors.lastname: Magriples
authors.forename: Trace S
authors.initials: TS
authors.lastname: Kershaw
authors.forename: Sharon Schindler
authors.initials: SS
authors.lastname: Rising
authors.forename: Claire
authors.initials: C
authors.lastname: Westdahl
authors.forename: Jeannette R
authors.initials: JR
authors.lastname: Ickovics
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D015984:Causality; D002585:Cesarean Section / Q000706:statistics & numerical data; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D009765:Obesity / Q000453:epidemiology*; D007744:Obstetric Labor Complications / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D015430:Weight Gain; D055815:Young Adult