Association of extremes of prepregnancy BMI with the clinical presentations of preterm birth

作者：Lynch Anne M^*; Hart Jan E; Agwu Ogechi C; Fisher Barbra M; West Nancy A; Gibbs Ronald S

来源：American Journal of Obstetrics and Gynecology, 2014, 210(5): 428.e1.

DOI：10.1016/j.ajog.2013.12.011

• phenotypic
• prepregnancy BMI
• preterm birth

OBJECTIVE: The purpose of this study was to examine associations between the prepregnancy maternal body mass index (BMI) across the 3 clinical presentations of preterm birth (PTB).
STUDY DESIGN: We conducted a retrospective cohort study of the records of 11,726 women. The World Health Organization International Classification was used to categorize BMI. The primary outcome of the study was PTB (< 37 weeks' gestation) presenting as spontaneous preterm labor, preterm premature rupture of the membranes, or a medical indication. We used univariable and multivariable logistic regression analysis to analyze the data (P <.05).
RESULTS: We found (1) a significant increase in the overall incidence of PTB at the extremes of BMI, (2) a higher risk for PTB from spontaneous preterm labor at the lower extremes (low plus moderate thinness) of BMI (adjusted odds ratio [aOR], 2.4; 95% confidence interval [CI], 1.4-4.2; P= .003), (3) a higher risk for preterm premature rupture of the membranes at the upper extremes (obese class II plus III) of BMI (aOR, 1.6; 95% CI, 1.1-2.3; P=.02), and (4) a higher risk for a medically indicated PTB at the lower (aOR, 2.8; 95% CI, 1.4-5.6; P=.004) and upper (aOR, 1.5; 95% CI, 1.1-2.2; P=.02) extreme of BMI.
CONCLUSION: Women at the extremes of prepregnancy BMI are at risk for PTB.

• 出版日期2014-5