TY - JOUR
T1 - Maternal BMI and preterm birth
T2 - A systematic review of the literature with meta-analysis
AU - Torloni, Maria Regina
AU - Betrán, Ana Pilar
AU - Daher, Silvia
AU - Widmer, Mariana
AU - Dolan, Siobhan M.
AU - Menon, Ramkumar
AU - Bergel, Eduardo
AU - Allen, Tomas
AU - Merialdi, Mario
N1 - Funding Information:
1Department of Obstetrics, São Paulo Federal University, São Paulo, Brazil, 2Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland, 3Department of Obstetrics and Gynecology and Women’s Health, Albert Einstein College of Medicine, New York, USA, 4Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, USA, and 5Department of Knowledge Management and Sharing, World Health Organization, Geneva, Switzerland
PY - 2009/11
Y1 - 2009/11
N2 - Objectives.To examine the association between high prepregnancy maternal body mass index BMI and the risk of preterm birth PTB. Methods.A systematic review of the literature. We included cohorts and case-control studies published since 1968 that examined the association between BMI and PTB of all types, spontaneous (s), elective and with ruptured membranes (PPROM) in three gestational age categories: general (<37 weeks), moderate (32-36 weeks) and very (<32 weeks) PTB. Results.20,401 citations were screened and 39 studies (1,788,633 women) were included. Preobese (BMI, 25-29.9) and obese I (BMI, 3034.9) women have a reduced risk for sPTB: AOR 0.85 (95% CI: 0.80-0.92) and 0.83 (95% CI: 0.75-0.92), respectively. Their risk for moderate PTB was 1.20 (95% CI: 1.04-1.38) and 1.60 (95% CI: 1.32-1.94), respectively. Obese II women (BMI, 35-40) have an increased risk for PTB in general (AOR=1.33, 95% CI: 1.12-1.57) moderate (AOR=2.43, 95% CI: 1.46-4.05) and very PTB (AOR=1.96, 95% CI: 1.66-2.31). Obese III women (BMI > 40) have an even higher risk for very PTB (AOR=2.27, 95CI: 1.762.94). High BMI does not modify the risk for PPROM and increases the risk for elective PTB. Conclusions.High maternal BMI may have different effects on different types of PTB.
AB - Objectives.To examine the association between high prepregnancy maternal body mass index BMI and the risk of preterm birth PTB. Methods.A systematic review of the literature. We included cohorts and case-control studies published since 1968 that examined the association between BMI and PTB of all types, spontaneous (s), elective and with ruptured membranes (PPROM) in three gestational age categories: general (<37 weeks), moderate (32-36 weeks) and very (<32 weeks) PTB. Results.20,401 citations were screened and 39 studies (1,788,633 women) were included. Preobese (BMI, 25-29.9) and obese I (BMI, 3034.9) women have a reduced risk for sPTB: AOR 0.85 (95% CI: 0.80-0.92) and 0.83 (95% CI: 0.75-0.92), respectively. Their risk for moderate PTB was 1.20 (95% CI: 1.04-1.38) and 1.60 (95% CI: 1.32-1.94), respectively. Obese II women (BMI, 35-40) have an increased risk for PTB in general (AOR=1.33, 95% CI: 1.12-1.57) moderate (AOR=2.43, 95% CI: 1.46-4.05) and very PTB (AOR=1.96, 95% CI: 1.66-2.31). Obese III women (BMI > 40) have an even higher risk for very PTB (AOR=2.27, 95CI: 1.762.94). High BMI does not modify the risk for PPROM and increases the risk for elective PTB. Conclusions.High maternal BMI may have different effects on different types of PTB.
KW - Adiposity
KW - Body mass index
KW - Literature review
KW - Meta-analysis
KW - Obesity
KW - Overweight
KW - Premature birth
KW - Preterm labor
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U2 - 10.3109/14767050903042561
DO - 10.3109/14767050903042561
M3 - Article
C2 - 19900068
AN - SCOPUS:70350321087
SN - 1476-7058
VL - 22
SP - 957
EP - 970
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 11
ER -
