Pre‐pregnancy BMI, rate of gestational weight gain, and preterm birth among US Pacific Islander individuals

Abstract

ObjectiveThe objective of this study was to examine the association between rate of gestational weight gain (GWG) and preterm birth (PTB) classified by pre‐pregnancy BMI among Pacific Islander individuals in the United States.MethodsPacific Islander mothers (n = 55,975) and singleton infants (22–41 gestational weeks) without congenital anomalies were included using data from the National Center for Health Statistics (2014–2018). PTB was compared by pre‐pregnancy BMI among women in each stratum of rate of GWG using Cox proportional hazards models.ResultsCompared with mothers with a rate of GWG within the guidelines, mothers with a rate of GWG below the guidelines and either pre‐pregnancy underweight (adjusted hazard ratio [aHR] = 1.84, 95% CI: 1.10–3.06), healthy weight (aHR = 1.38, 95% CI: 1.15–1.65), obesity class I (aHR = 1.22, 95% CI: 0.97–1.52), or obesity class II (aHR = 1.43, 95% CI: 1.05–1.96) had an increased risk of PTB; mothers with a rate of GWG above the guidelines and either pre‐pregnancy underweight (aHR = 1.57, 95% CI: 0.92–2.69) or obesity class II (aHR = 1.31, 95% CI: 0.98–1.76) had an increased risk of PTB.ConclusionsThe association between rate of GWG below or above the guidelines and PTB differs by pre‐pregnancy BMI among Pacific Islander individuals.

Diabetes Mellitus as a Risk Factor for Spontaneous Preterm Birth in Women with a Short Cervix after Ultrasound-Indicated Cerclage

“…Conversely, recent systematic reviews suggest that women with a BMI of 35 kg/m 2 or higher are at greater risk of experiencing very preterm birth (before 32 weeks) and moderate preterm birth (between 32 and 36 weeks) [31,35]. Further, several studies have underscored an elevated risk of extremely preterm birth (before 28 weeks) in women with a BMI of 30 kg/m 2 or higher [35][36][37][38]. Shaw et al, in a detailed population-based study, found an increased risk of preterm birth before 27 weeks among mothers with severe obesity, noting that this risk varies by ethnicity and parity [39].…”