title: Pregnancy, obesity, gestational weight gain, and parity as predictors of peripartum complications.
abstract: OBJECTIVE
  To determine if the best predictor of pregnancy complications is pre-pregnancy body mass index (BMI) alone or in combination with other factors.
  
  
  METHODS
  BMI and peripartum outcomes of singleton pregnancies were evaluated. Recursive partitioning and logistic regression modeling was used.
  
  
  RESULTS
  Of the 4,286 cohorts, 26% were obese (BMI >30 kg/m(2)) and, compared to cohorts with normal weight, at risk for wound infections (P < 0.001), and shoulder dystocia (P < 0.001). High-risk patients (15%; BMI >32.5, parity, pregnancy weight gain of 28 lb by 28 weeks) were at increased risk for wound infection (P < 0.001), endometritis (P < 0.001), shoulder dystocia (P = 0.001) and 5 min Apgar score <4 (P < 0.041) and at lower risk for pre-term delivery (P = 0.007).
  
  
  CONCLUSIONS
  Since BMI, parity, and weight gain until 28 weeks together provide better prediction of peripartum complications than BMI alone, these characteristics can be used to triage and refer patients.
authors.affiliation: Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, 4301 W. Markham St. Slot # 518, Little Rock, AR 72205, USA. efmagann@uams.edu
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.forename: Dorota A
authors.initials: DA
authors.lastname: Doherty
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Klimpel
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Huff
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D004420:Dystocia / Q000453:epidemiology / Q000209:etiology; D004716:Endometritis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008922:Mississippi / Q000453:epidemiology; D009765:Obesity; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000209:etiology; D010298:Parity; D058725:Peripartum Period; D011247:Pregnancy; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D015430:Weight Gain; D055815:Young Adult