title: Pre-pregnancy maternal obesity and the risk of preterm preeclampsia in the American primigravida.
abstract: To estimate the risk of preterm preeclampsia in primiparous women by pre-pregnancy obesity class.
  
  
  
  A retrospective cohort study of primiparous women with singleton gestations was performed for deliveries from January 2003 to April 2014. Cases were stratified by delivery occurring either at ≥ 37 weeks or < 37 weeks. Pre-pregnancy maternal obesity was defined as a body mass index (BMI) ≥ 30 kg/m(2) . World Health Organization criteria were used to define BMI class of obesity. Multinomial logistic regression modeling estimated the association between term and preterm preeclampsia and pre-pregnancy obesity.
  
  
  
  Of 28,361 women with complete pre-pregnancy BMI data, 2,588 women (9.1%) had a diagnosis of preeclampsia. Women who developed preeclampsia prior to 37 weeks (n = 784) were more likely to be women with obesity compared to women who developed preeclampsia after 37 weeks (33.1% vs. 25.3%, P = 0.0001). Compared to normal-weight women without preeclampsia, the risk of preterm preeclampsia increased proportionally with pre-pregnancy obesity class, with women with a BMI ≥ 40 kg/m(2) having the greatest risk (RR 5.23, 95% CI: 3.86-7.09, P <0.001).
  
  
  
  The risk of preterm preeclampsia increased significantly as the severity of maternal pre-pregnancy obesity increased. Reduction in maternal pre-pregnancy BMI may be protective in mitigating such risk.
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
authors: Omar M
authors: OM
authors: Young
authors: Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital/University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors: Roxanna
authors: R
authors: Twedt
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital/University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.|Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors: Janet M
authors: JM
authors: Catov
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D020073:Gravidity; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D050177:Overweight / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology