Intrapartum outcomes associated with change in body mass index category during pregnancy

Abstract

MASS INDEX CATEGORY DURING PREGNANCY WANJIKU KABIRU, B. DENISE RAYNOR, Emory University, OB/GYN, Atlanta, GA OBJECTIVE: To investigate the effect of change in body mass index (BMI) category on intrapartum outcomes. STUDY DESIGN: Retrospective cohort study conducted from 1999 to 2002. Women with term singleton pregnancies were included. BMI categories were defined as normal 25-29.9, overweight 30-34.5, obese 35-39.9, and morbid obesity $40. Change in BMI category was calculated by subtracting prepregnancy BMI category from BMI category at delivery. Analysis was performed with one-way ANOVA for continuous variables and chi-square test for trend for categorical variables. Multivariate analysis was performed to evaluate the relationship between outcomes, change in BMI categories, and other covariables. RESULTS: 10,880 singleton, term pregnancies were identified in the Grady Memorial Hospital database. Of these, 5802 had complete obstetric data. 3163 (29.1%) women remained in the same BMI category during pregnancy, 2330 (21.4%) increased by 1 BMI category, and 309 (2.8%) increased by 2 categories. Demographics and prenatal characteristics were similar. Change in BMI category was associated with decreased risk of intrauterine growth restriction (P < 0.001). Intrapartum outcomes differed between groups (Table). CONCLUSION:Change in BMI category is associated with failed induction, amnionitis, lacerations, and operative delivery.