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Role of Body Mass Index and gestational weight gain on preterm birth and adverse perinatal outcomes

2019; Nature Portfolio; Volume: 9; Issue: 1 Linguagem: Inglês

10.1038/s41598-019-49704-x

2045-2322

Fabia Pigatti Silva, Renato T. Souza, José Guilherme Cecatti, Renato Passini, Ricardo Porto Tedesco, Giuliane Jesus Lajos, Marcelo Luís Nomura, Patrícia Moretti Rehder, Tábata Z. Dias, Paulo F. Oliveira, Cleide M. Silva, Maria Laura Costa, Rodolfo C. Pacagnella, Samira M. Haddad, Vilma Zotarelli, Lucio T. Gurgel, Nelson Lourenço Maia Filho, Jacinta P. Mathias, Sérgio Tadeu Martins Marba, Ruth Guinsburg, Francisco Eulógio Martinez, Silvana Maria Quintana, Patrícia P. S. Melli, Francisco Edson de Lucena Feitosa, George N. Chaves, Ana Maria Feitosa Porto, Isabela Coutinho, Antonio C. Barbosa Lima, Elias F. Melo, Débora F. Leite, Melânia Maria Ramos Amorim, Adriana Suely Oliveira Melo, Fabiana O. Melo, Marília G. Martins, Marinea V. Nunes, Cláudio Sérgio Medeiros Paiva, Moisés Diôgo de Lima, Djacyr Magna Cabral Freire, Edson Gomes Tristão, Dênis José Nascimento, Carlos A. S. Menezes, Marcelo de Amorim Aquino, Janete Vettorazzi, Cintia E. Senger, Augusta M. B. Assumpção, Marcela A. F. Guedes, Maria Elizabeth Lopes Moreira, Vera Therezinha Medeiros Borges, Eduardo de Souza, Ana Cristina Perez Zamarian, Fátima Aparecida Henrique Lotufo, Kaliane P. Uzilin, Elvira A. O. Zanette, Carla Betina Andreucci, Tenílson Amaral Oliveira, Laércio R. Oliveira, Marcos Antonio Nogueira Santos, Nelson Sass, Mirian R. F. Silveira, Pedro R. Coutinho, Luciana T. Siqueira,

Pregnancy and preeclampsia studies

Abstract The association of body mass index (BMI) and gestational weight gain (GWG) with preterm birth (PTB) remains controversial in the literature. To evaluate different maternal BMI and GWG categories, according to the initial BMI, in relation to different PTB subtypes and perinatal outcomes, we conducted a secondary analysis of a multicentre cross-sectional study, along with a nested case-control study including PTB from 20 centers in Brazil. Pre-pregnancy underweight was associated with a lower risk of provider-initiated PTB, while overweight and obesity were associated with a higher risk of provider-initiated PTB and a lower risk of spontaneous preterm birth. Insufficient gestational weight gain was associated with a higher prevalence of spontaneous PTB and preterm premature rupture of membranes. Excessive GWG correlated with a higher prevalence of provider-initiated PTB or preterm premature rupture of membranes. Irrespective of the initial BMI, the greater the rate of GWG, the higher the predicted probability of all PTB subtypes, except for spontaneous PTB in underweight women and those with normal BMI. On multivariate analysis, the initial BMI was shown to be the only factor associated with pi-PTB. Briefly, further studies evaluating the risk for PTB should consider that GWG may have a different role depending on the initial BMI and PTB subtype.