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Maternal early pregnancy body mass index and risk of preterm birth

  • Materno-fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To determine the association between maternal body mass index (BMI) in early pregnancy and the risk of preterm birth (PTB) in Chinese women.

Methods

Data were obtained from a population-based perinatal care program in China during 1993–2005. Women whose height and weight information was recorded at the first prenatal visit in the first trimester of pregnancy and delivered a singleton live infant were selected. Women with multiple gestations, stillbirths, delivery before 28 weeks or after 44 weeks of gestation, and infants affected by major external birth defects were excluded. BMI was categorized as underweight (less than 18.5 kg/m2), normal weight (18.5–23.9 kg/m2), overweight (24–27.9 kg/m2), and obese (≥28 kg/m2) based on BMI classification criteria for Chinese. Logistic regression analysis was conducted to adjust for potential confounders, such as maternal age, education, occupation, city or county, gender of infant, and year of delivery.

Results

A total of 353,477 women were selected. The incidence of preterm birth in women who were underweight, normal weight, overweight, obese was 3.69% (3.61–3.76%), 3.59% (3.55–3.62%), 3.83% (3.71–3.96%), 4.90% (4.37–5.43%), respectively. The incidence of elective preterm birth, overweight, and obesity increased remarkably during 2000–2005 compared with that during 1993–1996. After having adjusted for potential confounders including maternal age, maternal occupation, education, city or county, gender of the infant and year of birth, the risk of PTB increased significantly with BMI (P < 0.05). Among nulliparae, the risk of elective preterm birth increased with increasing BMI. Nulliparae who were underweight were less likely to deliver elective preterm births (OR = 0.89, 95% CI 0.80–0.98). Nulliparae who were overweight and obese in early pregnancy were at a greater risk of elective PTB than normal weight nulliparae (for the overweight OR = 1.36, 95% CI 1.18–1.56, for the obese OR = 2.94, 95% CI 2.04–4.25).

Conclusion

In this study, indigenous Chinese cohort women who are overweight, obese, and nulliparous are at an increased risk of elective preterm birth.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

IRB:

Institutional review board

MCH:

Maternity and child health

NCMIH:

National Center for Maternal and Infant Health

OR:

Odds ratio

PTB:

Preterm birth

PHCSS:

Perinatal Health Care Surveillance System

SD:

Standard deviation

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Acknowledgments

We gratefully acknowledge the help of Professor Cande V Ananth (Director of Division of Epidemiology and Biostatistics Department of Obstetrics, Gynecology, and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, New Brunswick NJ) who has offered us valuable suggestions, insightful criticism and expert guidance in the preparation and revise of the manuscript.

Conflict of interest

The authors have no potential conflicts of interest to disclose.

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Authors and Affiliations

  1. School of Public Health Peking University Health Science Center, 38 Xueyuan Rd Haidian District, 100191, Beijing, People’s Republic of China

    Ting Wang, Xinrong Lu, Wei Xi & Zhu Li

  2. Tanggu Center for Disease Control and Prevention, 43 Fujian Road, Tanggu District, 300450, Tianjin, China

    Ting Wang

  3. Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, 200092, Shanghai, China

    Jun Zhang

  4. School of Public Health, Tianjin Medical University, 300100, Tianjin, China

    Wei Xi

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  1. Ting Wang
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Correspondence to Zhu Li.

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Wang, T., Zhang, J., Lu, X. et al. Maternal early pregnancy body mass index and risk of preterm birth. Arch Gynecol Obstet 284, 813–819 (2011). https://doi.org/10.1007/s00404-010-1740-6

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  • DOI: https://doi.org/10.1007/s00404-010-1740-6

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