Risk of early birth by body mass index in a propensity score-matched sample: A retrospective cohort study

Rebecca J. Baer, Brittany D. Chambers, Kimberly Coleman-Phox, Elena Flowers, Jonathan D. Fuchs, Scott P. Oltman, Karen A. Scott, Kelli K. Ryckman, Larry Rand, Laura L. Jelliffe-Pawlowski

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Evaluate the risk of preterm (<37 weeks) or early term birth (37 or 38 weeks) by body mass index (BMI) in a propensity score-matched sample. Design: Retrospective cohort analysis. Setting: California, USA. Population: Singleton live births from 2011–2017. Methods: Propensity scores were calculated for BMI groups using maternal factors. A referent sample of women with a BMI between 18.5 and <25.0 kg/m2 was selected using exact propensity score matching. Risk ratios for preterm and early term birth were calculated. Main outcome measures: Early birth. Results: Women with a BMI <18.5 kg/m2 were at elevated risk of birth of 28–31 weeks (relative risk [RR] 1.2, 95% CI 1.1–1.4), 32–36 weeks (RR 1.3, 95% CI 1.2–1.3), and 37 or 38 weeks (RR 1.1, 95% CI 1.1–1.1). Women with BMI ≥25.0 kg/m2 were at 1.2–1.4-times higher risk of a birth <28 weeks and were at reduced risk of a birth between 32 and 36 weeks (RR 0.8–0.9) and birth during the 37th or 38th week (RR 0.9). Conclusion: Women with a BMI <18.5 kg/m2 were at elevated risk of a preterm or early term birth. Women with BMI ≥25.0 kg/m2 were at elevated risk of a birth <28 weeks. Propensity score-matched women with BMI ≥30.0 kg/m2 were at decreased risk of a spontaneous preterm birth with intact membranes between 32 and 36 weeks, supporting the complexity of BMI as a risk factor for preterm birth. Tweetable abstract: Propensity score-matched women with BMI ≥30 kg/m2 were at decreased risk of a late spontaneous preterm birth.

Original languageEnglish (US)
Pages (from-to)1704-1711
Number of pages8
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume129
Issue number10
DOIs
StatePublished - Sep 2022

Keywords

  • body mass index
  • early
  • early term birth
  • preterm birth
  • propensity-matched sample
  • risk factor
  • spontaneous preterm birth

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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