Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes

Abstract

Objective In nonpregnant populations the waist to hip ratio (WHR) is a better predictor of obesity related outcomes than BMI. Our objective was to determine, in pregnancy, the relationship between these measures of obesity and LGA and cesarean delivery (CD). Methods This is a secondary analysis of data from the Combined Antioxidant and Preeclampsia Prediction Study (CAPPS). Women a WHR of ≥0.85 and 0.80–0.84 at 9–16 weeks gestation, were compared to those with a WHR <0.80. Women with early pregnancy BMI ≥ 30.0 kg/m2 (obese) and 25.0–29.9 kg/m2 (overweight) were compared to those <25.0 kg/m2. LGA was defined as >90% by Alexander nomogram. Univariable analysis, logistic regression and ROC curves were used. Results Data from 2,276 women were analyzed. After correcting for potential confounders, only BMI ≥ 30 was significantly associated with LGA (aOR 2.07, 1.35–3.16) while BMI 25.0–29.9 (aOR 1.5, 0.98–2.28), WHR 0.8–0.84 (aOR 1.33, 0.83–2.13) and WHR≥0.85, (aOR 1.05, 0.67–1.65) were not. Risk for CD was increased for women with elevated WHR and with higher BMI compared to normal. Conclusion WHR is not associated with LGA. While BMI performed better than WHR, neither was a strong predictor of LGA or need for CD in low risk nulliparous women.

Impact of maternal central adiposity on infant anthropometry and perinatal morbidity: A systematic review

“…1 . In total, 10 cohort studies published from 1996 to 2019 fulfilled the inclusion criteria and were included in this systematic review [ 11 , 12 , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] ] ( Table 1 ). The quality of the studies and risk of bias according to the Newcastle-Ottawa Quality Assessment Scale for cohort studies are listed in Table A.1.…”

“…McDonnold et al [ 18 ] compared the likelihood of giving birth to an LGA infant and having a cesarean section among 2276 pregnant women with WHR < 0.80, 0.80−0.84, or ≥ 0.85, measured at 9−16 weeks of gestation. There were no observed associations between high WHR and LGA birth ( Table 1 ), which was only predicted by early pregnancy BMI ≥ 30 kg/m 2 .…”

“…A summary of the authors’ subjective evaluation of the evidence for the different offspring outcomes is presented in Table A.2. The included studies used several different proxies for maternal central adiposity: ultrasonography was adopted to measure abdominal SFT in three studies [ 11 , 12 , 22 ] and VAT in one study [ 19 ], while two studies used WC [ 20 , 21 ] and four WHR [ [15] , [16] , [17] , [18] ]. There was a moderate consistency in the observed associations for the different measurement methods ( Table 1 ).…”

Association between homocysteine, vitamin B12, folic acid and erectile dysfunction: a cross-sectional study in China

“…Among them, BMI and WHR are the indexes applied to estimate obesity. However, BMI tends to evaluate body fatness but has a weak ability to differentiate fatness as central or visceral 17. Alternatively, WHR is said to be more effective in reflecting the visceral fat and central adiposity but is not suitable for an estimation of body fat 17 18.…”

“…However, BMI tends to evaluate body fatness but has a weak ability to differentiate fatness as central or visceral 17. Alternatively, WHR is said to be more effective in reflecting the visceral fat and central adiposity but is not suitable for an estimation of body fat 17 18. Additionally, the predictive effects of BMI and WHR in diseases are different 19 20.…”