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dc.contributor.authorKnight-Agarwal, Catherine R
dc.contributor.authorWilliams, Lauren T
dc.contributor.authorDavis, Deborah
dc.contributor.authorDavey, Rachel
dc.contributor.authorCochrane, Tom
dc.contributor.authorZhang, Huanhua
dc.contributor.authorRickwood, Peter
dc.date.accessioned2017-08-28T00:04:26Z
dc.date.available2017-08-28T00:04:26Z
dc.date.issued2016
dc.identifier.issn2044-6055
dc.identifier.doi10.1136/bmjopen-2015-010667
dc.identifier.urihttp://hdl.handle.net/10072/124033
dc.description.abstractObjective: To assess maternal and neonatal outcomes associated with increasing body mass index (BMI) and interpregnancy BMI changes in an Australian obstetric population. Methods: A retrospective cohort study from 2008 to 2013 was undertaken. BMI for 14 875 women was categorised as follows: underweight (≤18 kg/m2); normal weight (19–24 kg/m2); overweight (25–29 kg/m2); obese class I (30–34 kg/m2); obese class II (35–39 kg/m2) and obese class III (40+ kg/m2). BMI categories and maternal, neonatal and birthing outcomes were examined using logistic regression. Interpregnancy change in BMI and the risk of adverse outcomes in the subsequent pregnancy were also examined. Results: Within this cohort, 751 (5.1%) women were underweight, 7431 (50.0%) had normal BMI, 3748 (25.1%) were overweight, 1598 (10.8%) were obese class I, 737 (5.0%) were obese class II and 592 (4.0%) were obese class III. In bivariate adjusted models, obese women were at an increased risk of caesarean section, gestational diabetes, hypertensive disorders of pregnancy and neonatal morbidities including macrosomia, large for gestational age (LGA), hypoglycaemia, low 5 min Apgar score and respiratory distress. Multiparous women who experienced an interpregnancy increase of ≥3 BMI units had a higher adjusted OR (AOR) (CI) of the following adverse outcomes in their subsequent pregnancy: low 5-min Apgar score 3.242 (1.557 to 7.118); gestational diabetes mellitus (GDM) 3.258 (1.129 to 10.665) and hypertensive disorders of pregnancy 3.922 (1.243 to 14.760). These women were more likely to give birth vaginally 2.030 (1.417 to 2.913). Conversely, women whose parity changed from 0 to 1 and who experienced an interpregnancy increase of ≥3 BMI units had a higher AOR (CI) of caesarean section in their second pregnancy 1.806 (1.139 to 2.862). Conclusions: Women who are overweight or obese have a significantly increased risk of various adverse outcomes. Interpregnancy weight gain, regardless of parity and baseline BMI, also increases various adverse outcomes. Effective weight management strategies are needed.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBMJ Publishing Group
dc.relation.ispartofpagefrome010667-1
dc.relation.ispartofpagetoe010667-10
dc.relation.ispartofissue5
dc.relation.ispartofjournalBMJ Open
dc.relation.ispartofvolume6
dc.subject.fieldofresearchObstetrics and Gynaecology
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchOther Medical and Health Sciences
dc.subject.fieldofresearchcode111402
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1117
dc.subject.fieldofresearchcode1199
dc.titleAssociation of BMI and interpregnancy BMI change with birth outcomes in an Australian obstetric population: a retrospective cohort study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttp://creativecommons.org/licenses/by-nc/4.0/
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© The Author(s) 2016. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
gro.hasfulltextFull Text
gro.griffith.authorWilliams, Lauren T.


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