The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #54847

Terry J. Rosenberg, PhD, Research and Evaluation Unit, Medical and Health Research Association of New York City, Inc., 40 Worth Street, Suite 720, New York, NY 10013, 212-285-0220, trosenberg@mhra.org, Samantha Garbers, MPA, Research & Evaluation, Medical & Health Research Association of New York City, Inc., 40 Worth Street, Suite 720, New York, NY 10013, and Mary Ann Chiasson, DrPH, Research and Evaluation Unit, Medical and Health Research Association of New York City, 40 Worth Street Suite 720, New York, NY 10013.

This study examines the effect of prepregnancy obesity and the added effect of excessive prenatal weight gain on adverse outcomes among obese women. Data from a 1998-1999 New York City (NYC) births file for 213,208 singleton births with information on prepregnancy weight and prenatal weight gain are used. Maternal height is not available to compute a BMI. Prepregnancy weight was categorized and used in logistic regressions to predict gestational diabetes, preeclampsia, cesarean delivery, macrosomia and treatment in the Neonatal Intensive Care Unit (NICU). Prenatal weight gain was also categorized and used to predict the same outcomes for 13,312 women weighing >=200 pounds prepregnancy. Controls included mother's age, race/ethnicity, marital status, education, social risk (e.g. smoking), prenatal care, and health insurance. Prepregnancy weight affects several adverse outcomes, adjusting for controls. In logistic regressions comparing the heaviest group (>=300 pounds) to the lightest group (<100 pounds) the adjusted odds ratios (AOR) are 8.9 for gestational diabetes, 6.9 for preeclampsia, 2.8 for cesarean delivery, 12.8 for macrosomia, and 1.7 for infant admission to the NICU. For mothers weighing 200 pounds or more before pregnancy, excessive prenatal weight gain is further related to adverse outcomes. The AORs for those gaining more than 35 pounds are 1.5 for preeclampsia, 1.2 for a cesarean section, and 1.4 for a macrosomic infant, when compared to those gaining 16-25 pounds. For all overweight and obese women the costs of adverse outcomes from excessive weight underline the urgency of weight loss interventions in the preconception, prenatal, and postpartum periods.

Learning Objectives:

From this session participants will: (
• Learn about the association between prepregnancy obesity and birth outcomes; (
• Learn about the association between prenatal weight gain and birth outcomes for obese mothers; (
• Identify the demographic and health care factors that affect these associations; (
• Hear recommendations for preconception and prenatal weight control to improve birth outcomes for high risk groups.

Keywords: Pregnancy Outcomes, Obesity

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.