Abstract
BackgroundInternational studies on the association between maternal body mass index (BMI) and spontaneous preterm birth (PTB) yield controversial results warranting large studies from other settings. The aim of this article was to study association between maternal early pregnancy BMI and the risk of spontaneous PTB in Murmansk County (MC), Northwest Russia.MethodsThis is a registry-based cohort study. All women with singleton pregnancies registered at antenatal clinics during the first 12 weeks of gestation and who delivered in MC between January, 1st 2006 and December, 31st 2011 comprised the study base (n = 29,709). All women were categorized by BMI into four groups: underweight (<18.5 kg/m2), normal (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30.0 kg/m2). Multivariable logistic regression was used to study associations between maternal BMI and PTB (<37 weeks) and very preterm birth (VPTB) (<32 weeks) adjusted for socio-economic factors, biological and lifestyle characteristics.ResultsThe prevalence of underweight, overweight and obesity were 7.1% (95% CI: 6.8-7.4), 18.3% (95% CI: 17.8-18.7) and 7.1% (95% CI: 6.8-7.4), respectively. Altogether, 5.5% (95% CI: 5.3-5.8) of the births were PTB and 0.8% (95% CI: 0.7-0.9) were VPTB. After adjustment, both underweight (OR = 1.25, 95% CI: 1.03-1.50), overweight (OR = 1.10, 95% CI: 0.97-1.26) and obese (OR = 1.31, 95% CI: 1.08-1.57) women were more likely to deliver preterm. VPTB was associated with overweight (OR = 1.47, 95% CI: 1.056-2.03) and obesity (OR = 1.63, 95% CI: 1.02-2.60).ConclusionThe findings demonstrate a J-shaped association between first trimester maternal BMI and spontaneous PTB and VPTB with increased risk among underweight, overweight and obese women.
Highlights
International studies on the association between maternal body mass index (BMI) and spontaneous preterm birth (PTB) yield controversial results warranting large studies from other settings
very preterm birth (VPTB) was associated with overweight (OR = 1.47, 95% confidence intervals (CI): 1.056-2.03) and obesity (OR = 1.63, 95% CI: 1.02-2.60)
Using data from the Murmansk County Birth Registry (MCBR) this study investigates associations between maternal BMI in early pregnancy and PTB
Summary
International studies on the association between maternal body mass index (BMI) and spontaneous preterm birth (PTB) yield controversial results warranting large studies from other settings. The aim of this article was to study association between maternal early pregnancy BMI and the risk of spontaneous PTB in Murmansk County (MC), Northwest Russia. The prevalence of underweight is much lower than the prevalence of overweight and obesity. Less than 4% of Russian women between the ages of 18 and 49 are underweight [2]. Despite such a low prevalence, underweight contributes to adverse pregnancy outcomes including preterm birth (PTB) representing a challenge for both obstetric and neonatal health care [3]. PTB is one of the main contributors to neonatal mortality, neonatal morbidity and childhood morbidity and is associated with considerable burden for health care system [9]
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