title: The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010.
abstract: The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000-2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes.
authors.affiliation: Department of Nursing, Franklin Pierce University, Portsmouth, NH 03801, USA.
authors.forename: Nancy
authors.identifier: 0000-0002-3753-8686
authors.initials: N
authors.lastname: Baugh
authors.affiliation: School of Nursing, University of Southern Maine, Portland, ME 04104, USA.
authors.forename: David E
authors.identifier: 0000-0003-4995-5126
authors.initials: DE
authors.lastname: Harris
authors.affiliation: Department of Mathematics and Statistics, University of Southern Maine, Portland, ME 04104, USA.
authors.forename: AbouEl-Makarim
authors.identifier: 0000-0002-3192-4674
authors.initials: AM
authors.lastname: Aboueissa
authors.affiliation: School of Nursing, University of Southern Maine, Portland, ME 04104, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Sarton
authors.affiliation: Department of Applied Medical Sciences, University of Southern Maine, Portland, ME 04104, USA.
authors.forename: Erika
authors.initials: E
authors.lastname: Lichter
mesh_terms: D000328:Adult; D004522:Educational Status; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D007182:Income; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008281:Maine / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology*; D012923:Social Class; D013851:Thinness / Q000453:epidemiology; D015430:Weight Gain; D055815:Young Adult