Relationships between pregnancy outcomes, biochemical markers and pre-pregnancy body mass index.
OBJECTIVE
We examined the relationships between pre-pregnancy maternal body mass index (BMI), pregnancy outcomes and biochemical markers.


METHODS
This study was conducted as a cross-sectional analysis.


METHODS
Korean women in their second and third trimesters of pregnancy were recruited at two hospitals in the metropolitan Seoul area. Pre-pregnancy BMI was categorized in four groups according to the Asia-Pacific standard.


METHODS
Fasting blood samples were obtained and analyzed for serum levels of homocysteine, folate and high-sensitivity C-reactive protein (hs-CRP). Concentrations of fetal fibronectin were assessed in the cervix and vagina, and cervical length was measured.


RESULTS
Obese subjects had a lower education level and a lower income level than subjects of normal weight. The level of maternal stress was positively associated with pre-pregnancy BMI. Normal weight subjects were more likely to eat breakfast and consume meals of appropriate size than the rest of our sample. In overweight and obese subjects, weight gain during pregnancy was significantly lower than in the underweight and normal subjects. High pre-pregnancy maternal BMI increased the risks of preterm delivery (odds ratio (OR)=2.85, confidence interval (CI)=1.20-6.74), low-birth-weight (LBW) infants (overweight subjects: OR=5.07, CI=1.76-14.63; obese subjects: OR=4.49, CI=1.54-13.13) and macrosomia. In obese subjects, the average serum folate level was significantly lower than in the underweight subjects. In obese subjects, the average serum hs-CRP level was significantly higher than in the rest of our sample.


CONCLUSIONS
Pregnancy outcomes are influenced by pre-pregnancy BMI. These findings suggest that women can minimize their risks of preterm delivery, LBW and macrosomia by maintaining normal pre-pregnancy BMI.
Han
Y S
YS
Department of Food and Nutrition, Hanyang University, no. 17 Haengdang-dong, Seongdong-gu, Seoul, South Korea.
Ha
E H
EH
Park
H S
HS
Kim
Y J
YJ
Lee
S S
SS
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D056911:Democratic People's Republic of Korea / Q000453:epidemiology; D005260:Female; D005492:Folic Acid / Q000378:metabolism*; D006710:Homocysteine / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012307:Risk Factors; D012959:Socioeconomic Factors; D015430:Weight Gain / Q000502:physiology*
D015415:Biomarkers; D006710:Homocysteine; D002097:C-Reactive Protein; D005492:Folic Acid
J Obstet Gynecol Neonatal Nurs. 2007 Jul-Aug;36(4):335-41
17594408
J Psychosom Res. 1967 Aug;11(2):213-8
6059863
N Engl J Med. 1992 Jan 2;326(1):69-70
1727072
Acta Obstet Gynecol Scand. 1977;56(3):247-53
560099
Scand J Gastroenterol. 2000 Sep;35(9):950-6
11063155
JAMA. 1996 Apr 10;275(14):1093-6
8601928
Am J Obstet Gynecol. 2009 Mar;200(3):271.e1-7
19136091
Eur J Epidemiol. 2009;24(11):697-705
19653107
Clin Obstet Gynecol. 1980 Mar;23(1):15-6
7363525
Am J Obstet Gynecol. 1987 May;156(5):1137-41
3578425
Clin Chem. 2001 Mar;47(3):418-25
11238291
Am J Clin Nutr. 2000 Apr;71(4):962-8
10731504
Obes Res. 1995 Sep;3 Suppl 2:267s-275s
8581786
Public Health Nutr. 2009 Apr;12(4):497-506
18547457
Obes Res. 1996 May;4(3):271-6
8732961
Matern Child Health J. 2008 Sep;12(5):557-67
17713848
Public Health Nurs. 2009 Jan-Feb;26(1):3-13
19154188
Am J Obstet Gynecol. 1998 Jul;179(1):135-9
9704778
Am J Clin Nutr. 2000 May;71(5 Suppl):1344S-52S
10799412
Am J Ther. 1997 Jul-Aug;4(7-8):275-81
10423620
Am J Clin Nutr. 1996 Apr;63(4):520-5
8599315
Cytokine. 2009 Jul;47(1):61-4
19505831
Am J Obstet Gynecol. 1993 Feb;168(2):538-42
8438924
N Engl J Med. 1996 Feb 29;334(9):567-72
8569824
Obstet Gynecol. 1993 Nov;82(5):829-32
8414332
Asia Pac J Clin Nutr. 2007;16(4):757-65
18042539
Clin Chem. 1982 Oct;28(10):2121-4
6812987
Int J Obes Relat Metab Disord. 2001 Oct;25(10):1416-20
11673760
Clin Biochem. 2007 Mar;40(5-6):330-5
17289011
Obes Res. 2004 Oct;12(10):1622-32
15536226
Br J Nutr. 2001 May;85 Suppl 2:S109-13
11509098
Obesity (Silver Spring). 2009 Nov;17(11):2106-9
19407807
Am J Obstet Gynecol. 2004 Dec;191(6):1851-7
15592264