title: Interpregnancy body mass index changes and risk of stillbirth.
abstract: OBJECTIVE
  To examine the association between interpregnancy body mass index (BMI) change and stillbirth.
  
  
  METHODS
  Retrospective study using Missouri maternally linked cohort files (1978-2005). A total of 218,389 women were used in the analysis. BMI was classified as: underweight (<18.5), normal (18.5-24.9), overweight (25-29.9), or obese (≥30.0). Weight change was defined based on BMI category (i.e. normal-normal, normal-obese, etc.). Cox proportional hazard regression models were used to generate adjusted hazard ratios (HR) and 95% CI for the risk of stillbirth in the second pregnancy.
  
  
  RESULTS
  Significant findings were associated with interpregnancy BMI changes involving overweight mothers becoming obese (HR = 1.4, 95% CI 1.1-1.7), normal-weight mothers becoming overweight (HR = 1.2, 95% CI 1.0-1.4) or obese (HR = 1.5, 95% CI 1.1-2.1), or obese mothers maintaining their obesity status across the two pregnancies (HR = 1.4, 95% CI 1.2-1.7). Other weight change categories did not show significant risk elevation for stillbirth.
  
  
  CONCLUSIONS
  BMI change appears to play an important role in subsequent stillbirth risk.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida, 2A Tampa General Circle, Tampa, FL 33606, USA. vwhitema@health.usf.edu
authors.forename: Valerie E
authors.initials: VE
authors.lastname: Whiteman
authors.forename: Luminita
authors.initials: L
authors.lastname: Crisan
authors.forename: Cheri
authors.initials: C
authors.lastname: McIntosh
authors.forename: A P
authors.initials: AP
authors.lastname: Alio
authors.forename: Jingyi
authors.initials: J
authors.lastname: Duan
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Marty
authors.forename: Hamisu M
authors.initials: HM
authors.lastname: Salihu
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008923:Missouri / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D011247:Pregnancy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D050497:Stillbirth / Q000453:epidemiology*; D013851:Thinness / Q000453:epidemiology*; D015430:Weight Gain / Q000502:physiology*