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01-04-2012 | Maternal-Fetal Medicine

Ethnic disparity in spontaneous preterm birth and maternal pre-pregnancy body mass index

Authors: Maria Regina Torloni, Stephen J. Fortunato, Ana Pilar Betrán, Scott Williams, Lina Brou, Cayce Owens Drobek, Mario Merialdi, Ramkumar Menon

Published in: Archives of Gynecology and Obstetrics | Issue 4/2012

Abstract

Purpose

To investigate differences in pre-pregnancy BMI status in patients with spontaneous preterm birth (PTB) compared with term birth and assess the role of ethnicity as a risk modifier in BMI-associated PTB.

Methods

A case–control study involving self-reported African American and Caucasian women delivering singletons in Nashville, TN, USA, 2003–2009. Maternal pre-pregnancy BMI was recorded in 447 PTB-cases (African American = 145, Caucasian = 302) and 1315 term-birth controls (African American = 522; Caucasian = 793). Crude and adjusted odds ratio (OR and AOR) for PTB were calculated using normal BMI (18.5–24.9 kg/m²) as reference. Age, education, marital status, income, smoking, parity, previous PTB and pregnancy weight gain were included as covariates in logistic regression.

Results

No significant differences were noted in the OR for PTB among different BMI categories when women of different ethnicity were combined. Odds of PTB were greater in obese than in normal weight Caucasian women, even after adjusting for confounders (AOR = 1.84, 95%CI [1.15, 2.95]). Obese African American women had a decreased crude OR for PTB, although this was not significant after adjusting for confounders (AOR = 0.72, 95%CI [0.38, 1.40]). The odds for early PTB (<32 weeks) were decreased in obese compared with normal weight African American women (OR = 0.23, 95%CI [0.08, 0.70]), whereas they were increased in obese compared with normal weight Caucasian women (OR = 2.30, 95%CI [1.32, 4.00]).

Conclusion

The risk for PTB in women with different pre-pregnancy BMI categories differs according to ethnicity.

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Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH et al (2010) The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ 88(1):31–38PubMedCrossRef

Callaghan WM, MacDorman MF, Rasmussen SA, Qin C, Lackritz EM (2006) The contribution of preterm birth to infant mortality rates in the United States. Pediatrics 118(4):1566–1573PubMedCrossRef

Menon R (2008) Spontaneous preterm birth, a clinical dilemma: etiologic, pathophysiologic and genetic heterogeneities and racial disparity. Acta Obstet Gynecol Scand 87(6):590–600PubMedCrossRef

Kramer MS, Coates AL, Michoud MC, Dagenais S, Hamilton EF, Papageorgiou A (1995) Maternal anthropometry and idiopathic preterm labor. Obstet Gynecol 86(5):744–748PubMedCrossRef

Sebire NJ, Jolly M, Harris J, Regan L, Robinson S (2001) Is maternal underweight really a risk factor for adverse pregnancy outcome? A population-based study in London. Br J Obstet Gynaecol 108(1):61–66CrossRef

Doherty DA, Magann EF, Francis J, Morrison JC, Newnham JP (2006) Pre-pregnancy body mass index and pregnancy outcomes. Int J Gynaecol Obstet 95(3):242–247PubMedCrossRef

Hendler I, Goldenberg RL, Mercer BM, Iams JD, Meis PJ, Moawad AH et al (2005) The Preterm Prediction Study: association between maternal body mass index and spontaneous and indicated preterm birth. Am J Obstet Gynecol 192(3):882–886PubMedCrossRef

Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW et al (2001) Maternal obesity and pregnancy outcome: a study of 287 213 pregnancies in London. Int J Obes 25(8):1175–1182CrossRef

Abu Yaacob S, Saad FA, Sharara HA, Khalifa L, Manther AA, Rashed YA (2002) The effect of obesity in pregnancy on perinatal outcome in Qatar. Qatar Med J 11(2):32–35

10.

Baeten JM, Bukusi EA, Lambe M (2001) Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 91(3):436–440PubMedCrossRef

11.

Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S (2007) Effect of Body Mass Index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 7:168PubMedCrossRef

12.

Cedergren MI (2004) Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 103(2):219–224PubMedCrossRef

13.

Nohr EA, Bech BH, Vaeth M, Rasmussen KM, Henriksen TB, Olsen J (2007) Obesity, gestational weight gain and preterm birth: a study within the Danish National Birth Cohort. Paediatr Perinat Epidemiol 21(1):5–14PubMedCrossRef

14.

Torloni MR, Betran AP, Daher S, Widmer M, Dolan SM, Menon R et al (2009) Maternal BMI and preterm birth: a systematic review of the literature with meta-analysis. J Matern Fetal Neonatal Med 22(11):957–970PubMedCrossRef

15.

Menon R, Pearce B, Velez DR, Merialdi M, Williams SM, Fortunato SJ et al (2009) Racial disparity in pathophysiologic pathways of preterm birth based on genetic variants. Reprod Biol Endocrinol 7:62PubMedCrossRef

16.

Menon R, Fortunato SJ, Edwards DR, Williams SM (2010) Association of genetic variants, ethnicity and preterm birth with amniotic fluid cytokine concentrations. Ann Hum Genet 74(2):165–183PubMedCrossRef

17.

Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines. Institute of Medicine; National Research Council 2009 May [cited 2009 Aug 8];1–336. Available from: URL: http://www.nap.edu/catalog/12584.html

18.

Abenhaim HA, Kinch RA, Morin L, Benjamin A, Usher R (2007) Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes. Arch Gynecol Obstet 275(1):39–43PubMedCrossRef

19.

Ancel PY, Saurel-Cubizolles MJ, Di Renzo GC, Papiernik E, Breart G (1999) Very and moderate preterm births: are the risk factors different? Br J Obstet Gynaecol 106(11):1162–1170PubMedCrossRef

20.

Callaway LK, Prins JB, Chang AM, McIntyre HD (2006) The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust 184(2):56–59PubMed

21.

Haas JS, Fuentes-Afflick E, Stewart AL, Jackson RA, Dean ML, Brawarsky P et al (2005) Prepregnancy health status and the risk of preterm delivery. Arch Pediatr Adolesc Med 159(1):58–63PubMedCrossRef

22.

Savitz DA, Dole N, Herring AH, Kaczor D, Murphy J, Siega-Riz AM et al (2005) Should spontaneous and medically indicated preterm births be separated for studying aetiology? Paediatr Perinat Epidemiol 19(2):97–105PubMedCrossRef

23.

Simhan HN, Bodnar LM (2006) Prepregnancy body mass index, vaginal inflammation, and the racial disparity in preterm birth. Am J Epidemiol 163(5):459–466PubMedCrossRef

24.

Smith GC, Shah I, Pell JP, Crossley JA, Dobbie R (2007) Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: a retrospective cohort study. Am J Public Health 97(1):157–162PubMedCrossRef

25.

Denison FC, Roberts KA, Barr SM, Norman JE (2010) Obesity, pregnancy, inflammation, and vascular function. Reproduction 140(3):373–385PubMedCrossRef

26.

Schmatz M, Madan J, Marino T, Davis J (2010) Maternal obesity: the interplay between inflammation, mother and fetus. J Perinatol 30(7):441–446PubMedCrossRef

27.

Zhang Y, Nadeau M, Faucher F, Lescelleur O, Biron S, Daris M et al (2009) Progesterone metabolism in adipose cells. Mol Cell Endocrinol 298(1–2):76–83PubMedCrossRef

28.

Aly H, Hammad T, Nada A, Mohamed M, Bathgate S, El-Mohandes A (2010) Maternal obesity, associated complications and risk of prematurity. J Perinatol 30(7):447–451PubMedCrossRef

29.

Schieve LA, Cogswell ME, Scanlon KS, Perry G, Ferre C, Blackmore-Prince C et al (2000) Prepregnancy body mass index and pregnancy weight gain: associations with preterm delivery. The NMIHS Collaborative Study Group. Obstet Gynecol 96(2):194–200PubMedCrossRef

30.

Salihu HM, Luke S, Alio AP, Wathington D, Mbah AK, Marty PJ et al (2009) The superobese mother and ethnic disparities in preterm birth. J Natl Med Assoc 101(11):1125–1131PubMed

31.

Goldenberg RL, Culhane JF, Iams JD, Romero R (2008) Epidemiology and causes of preterm birth. Lancet 371(9606):75–84PubMedCrossRef

32.

Moutquin JM (2003) Classification and heterogeneity of preterm birth. BJOG 110(Suppl 20):30–33PubMed

33.

Savitz DA, Blackmore CA, Thorp JM (1991) Epidemiologic characteristics of preterm delivery: etiologic heterogeneity. Am J Obstet Gynecol 164(2):467–471PubMed

34.

Menon R, Thorsen P, Vogel I, Jacobsson B, Morgan N, Jiang L et al (2008) Racial disparity in amniotic fluid concentrations of tumor necrosis factor (TNF)-alpha and soluble TNF receptors in spontaneous preterm birth. Am J Obstet Gynecol 198(5):533–534PubMedCrossRef

35.

Fattah C, Farah N, O’Toole F, Barry S, Stuart B, Turner MJ (2009) Body Mass Index (BMI) in women booking for antenatal care: comparison between selfreported and digital measurements. Eur J Obstet Gynecol Reprod Biol 144(1):32–34PubMedCrossRef

36.

Niedhammer I, Bugel I, Bonenfant S, Goldberg M, Leclerc A (2000) Validity of self-reported weight and height in the French GAZEL cohort. Int J Obes Relat Metab Disord 24(9):1111–1118PubMedCrossRef

37.

Villanueva EV (2001) The validity of self-reported weight in US adults: a population based cross-sectional study. BMC Public Health 1:11PubMedCrossRef

Title: Ethnic disparity in spontaneous preterm birth and maternal pre-pregnancy body mass index
Authors: Maria Regina Torloni
Stephen J. Fortunato
Ana Pilar Betrán
Scott Williams
Lina Brou
Cayce Owens Drobek
Mario Merialdi
Ramkumar Menon
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 4/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-011-2102-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ethnic disparity in spontaneous preterm birth and maternal pre-pregnancy body mass index

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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