TY - JOUR
T1 - Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes
AU - McDonnold, Mollie
AU - Mele, Lisa M.
AU - Myatt, Leslie
AU - Hauth, John C.
AU - Leveno, Kenneth J.
AU - Reddy, Uma M.
AU - Mercer, Brian M.
AU - Eunice Kennedy Shriver National Institute, Kennedy Shriver National Institute
AU - Child Health Human Development Maternal-Fetal Medicine Units (MFMU) Network, Health Human Development Maternal-Fetal Medicine Units (MFMU) Network
N1 - Funding Information:
The project described was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (HD34208, HD27869, HD40485, HD40560, HD40544, HD34116, HD40512, HD21410, HD40545, HD40500, HD27915, HD34136, HD27860, HD53118, HD53097, HD27917, and HD36801); the National Heart, Lung, and Blood Institute (NHLBI); and the National Center for Research Resources (NCRR) (M01 RR00080, UL1 RR024153, UL1 RR024989) and its contents do not necessarily represent the official views of NICHD, NHLBI, NCRR, or National Institute of Health.
Publisher Copyright:
Copyright © 2016 by Thieme Medical Publishers, Inc.
PY - 2016/1/20
Y1 - 2016/1/20
N2 - Objective In nonpregnant populations the waist-to-hip ratio (WHR) is a better predictor of obesity-related outcomes than body mass index (BMI). Our objective was to determine, in pregnancy, the relationship between these measures of obesity, and large-for-gestational age (LGA) and cesarean delivery (CD). Methods This is a secondary analysis of data from the Combined Antioxidant and Preeclampsia Prediction Study. Women with a WHR of ≥ 0.85 and 0.80 to 0.84 at 9 to 16 weeks gestation were compared with those with a WHR < 0.80. Women with early pregnancy BMI ≥ 30.0 kg/m2 (obese) and 25.0 to 29.9 kg/m2 (overweight) were compared with those < 25.0 kg/m2. LGA was defined as > 90% by Alexander nomogram. Univariable analysis, logistic regression, and receiver operating characteristic curves were used. Results Data from 2,276 women were analyzed. After correcting for potential confounders, only BMI ≥ 30 was significantly associated with LGA (adjusted odds ratio [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 with 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.
AB - Objective In nonpregnant populations the waist-to-hip ratio (WHR) is a better predictor of obesity-related outcomes than body mass index (BMI). Our objective was to determine, in pregnancy, the relationship between these measures of obesity, and large-for-gestational age (LGA) and cesarean delivery (CD). Methods This is a secondary analysis of data from the Combined Antioxidant and Preeclampsia Prediction Study. Women with a WHR of ≥ 0.85 and 0.80 to 0.84 at 9 to 16 weeks gestation were compared with those with a WHR < 0.80. Women with early pregnancy BMI ≥ 30.0 kg/m2 (obese) and 25.0 to 29.9 kg/m2 (overweight) were compared with those < 25.0 kg/m2. LGA was defined as > 90% by Alexander nomogram. Univariable analysis, logistic regression, and receiver operating characteristic curves were used. Results Data from 2,276 women were analyzed. After correcting for potential confounders, only BMI ≥ 30 was significantly associated with LGA (adjusted odds ratio [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 with 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.
KW - cesarean delivery
KW - large-for-gestational age
KW - obesity
KW - waist-to-hip ratio
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U2 - 10.1055/s-0035-1569986
DO - 10.1055/s-0035-1569986
M3 - Article
C2 - 26788786
AN - SCOPUS:84955106461
SN - 0735-1631
VL - 33
SP - 618
EP - 624
JO - American journal of perinatology
JF - American journal of perinatology
IS - 6
ER -