333: First and second trimester gestational weight gain and the risk of recurrent spontaneous preterm birth

Abstract

and the risk of recurrent spontaneous preterm birth Danielle Durie, Radhika Tirumala, David Hackney University of Rochester, Obstetrics and Gynecology, Rochester, NY, Rochester General Hospital, Obstetrics and Gynecology, Rochester, NY OBJECTIVE: To assess the association between first and second trimester gestational weight gain (GWG) and the risk of recurrent spontaneous preterm birth (sPTB). STUDY DESIGN: We performed a retrospective cohort study of all live spontaneous preterm (24 weeks). Subjects were excluded for missing weight gain data in the subsequent pregnancy, multifetal gestation, pre-gestational diabetes or gastrointestinal disease. Clinical variables were abstracted from direct review of medical records from both pregnancies. Weight gain at 24-28 weeks in the subsequent pregnancy was evaluated in order to avoid the bias of greater total weight gains in subjects who went to term. Logistic regression, adjusting for pre-pregnancy BMI and the clinical variables which were significant in univariate analysis, was used to assess the association of mid-trimester gestational weight gain with recurrent preterm birth. RESULTS: Of 166 included subjects, 48 (28.9%) had a recurrent sPTB. Subjects with recurrent sPTB were younger and had an earlier gestational age of index sPTB compared to those with a subsequent term delivery. GWG at 24-28 weeks was not associated with recurrence of sPTB (aOR 0.99, 95% CI 0.95-1.03). This remained non-significant when GWG was assessed as a binary variable dichotomized at the mean or quartile or when stratified by obesity. A post-hoc power analysis demonstrated sufficient power for a weight gain difference between groups of 5 pounds or more. Gestational age in the index pregnancy was the only variable significantly associated with recurrence of sPTB (aOR 1.29, 95% CI 1.11-1.49) in multivariate regression. CONCLUSION: In women with a prior sPTB, there is no association between first and second trimester weight gain and the risk of recurrence.