Class III Obesity and Unwanted Pregnancy Among Women with Live Births in New York City, 2004–2007

Abstract

Obesity is associated with numerous adverse health effects for pregnant women and their newborns. Unintended pregnancy is associated with suboptimal prenatal health behaviors and adverse birth outcomes. While research has suggested a link between obesity and unintended pregnancy, the evidence has been contradictory. Research has not focused on women at the highest level of obesity, Class III (body mass index ≥40). Pregnancy Risk Assessment Monitoring System data for 4,161 women in New York City with a live birth from 2004 to 2007 and complete data on pregnancy intention, height, and weight were examined. The primary outcome, having a live birth that resulted from an unwanted pregnancy (not wanted at that time or at any time in the future), was compared across 6 groups of pre-pregnancy body mass index (BMI). Logistic regression models adjusting for sociodemographic factors and stressors during pregnancy were conducted. The proportion of women reporting their pregnancy was unwanted increased with increasing BMI level to a high of 24 % among women with Class III obesity. After adjustment for confounding sociodemographic factors, women classified as Class III obese were significantly more likely than women with normal BMI to report an unwanted pregnancy [AOR = 2.81 (95 % CI: 1.41-5.60)]; this relationship held after adjusting for stressors during pregnancy. No significant association was found for women of other BMI groups. Previous analyses may have masked a relationship between BMI and unwanted pregnancy among women with Class III obesity. Further research exploring underlying mechanisms which are amenable to intervention is of critical public health importance.

Pre-pregnancy obesity and non-adherence to multivitamin use: findings from the National Pregnancy Risk Assessment Monitoring System (2009–2011)

“…Huber et al analyzed PRAMS database and reported that obese women are at higher risk of unintended pregnancy compared to normal weight women (AOR = 1.75, 95 % CI = 1.21–2.52) [ 33 ]. Similarly, Garbers et al found that obese women had more than twice the odds of unintended pregnancy (AOR = 2.81, 95 % CI = 1.41–5.60) [ 35 ]. Nevertheless, findings from the current study demonstrated that obese women had a higher odds of not using multivitamins even after adjusting for pregnancy intention.…”

Candidate gene study for smoking, alcohol use, and body weight in a sample of pregnant women

“…One such risk factor is pre-pregnancy weight [37], which is one of the most important indicators of preconception health that has been linked to multiple child health outcomes including fetal growth, birth weight, and subsequent child obesity [38]. In such cases, pregnancy planning may modify genetic influences underlying weight through an interaction mechanism that could either attenuate or exacerbate certain genetic effects.…”