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Obstetrics & Gynecology 2004;104:286-292
© 2004 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Body Mass Index Change Between Pregnancies and Small for Gestational Age Births

Christine J. Cheng, MD*, Kerry Bommarito, MPH*, Akihiko Noguchi, MD, MPH*{dagger}, William Holcomb, MD{ddagger} and Terry Leet, PhD*{ddagger}

From the *Department of Community Health, Saint Louis University School of Public Health; and Departments of {dagger}Pediatrics and {ddagger}Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, St. Louis, Missouri.

OBJECTIVE: To estimate whether maternal weight changes between pregnancies influence the risk for small for gestational age (SGA) births.

METHODS: SGA cases (n = 8,062) below the tenth percentile birth weight for gestational age were selected from liveborn singletons born of Missouri residents during 1989–1997. Normal weight controls (n = 8,062) were selected according to birth year. The risk of SGA from interpregnancy body mass index (BMI) change and other maternal factors was estimated using logistic regression analysis.

RESULTS: An increase in BMI between pregnancies decreased SGA risk (adjusted odds ratio = 0.8; 95% confidence interval 0.7, 1.0). Other risk factors were prior SGA (4.4; 4.0, 4.8), preeclampsia/eclampsia (2.6; 2.1, 3.2), maternal cardiac disease (1.8; 1.1, 2.9), inadequate weight gain (1.9; 1.8, 2.2), and cigarette smoking (1.9; 1.7, 2.3 for 1–9 cigarettes per day; 2.5; 2.2, 2.8 for 10–19/d; and 2.8; 2.5, 3.3 for 20/d or more).

CONCLUSION: Increase in interpregnancy BMI lowers SGA risk, but adequate weight gain during pregnancy is more effective.

LEVEL OF EVIDENCE: II-2






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