Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes

Mollie Mcdonnold, Lisa M. Mele, Leslie Myatt, John C. Hauth, Kenneth J. Leveno, Uma M. Reddy, Brian M. Mercer

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective In nonpregnant populations the waist-to-hip ratio (WHR) is a better predictor of obesity-related outcomes than body mass index (BMI). Our objective was to determine, in pregnancy, the relationship between these measures of obesity, and large-for-gestational age (LGA) and cesarean delivery (CD). Methods This is a secondary analysis of data from the Combined Antioxidant and Preeclampsia Prediction Study. Women with a WHR of ≥ 0.85 and 0.80 to 0.84 at 9 to 16 weeks gestation were compared with those with a WHR <0.80. Women with early pregnancy BMI ≥ 30.0 kg/m2 (obese) and 25.0 to 29.9 kg/m2 (overweight) were compared with those <25.0 kg/m2. LGA was defined as > 90% by Alexander nomogram. Univariable analysis, logistic regression, and receiver operating characteristic curves were used. Results Data from 2,276 women were analyzed. After correcting for potential confounders, only BMI ≥ 30 was significantly associated with LGA (adjusted odds ratio [aOR]: 2.07, 1.35–3.16) while BMI 25.0–29.9 (aOR: 1.5, 0.98–2.28), WHR 0.8–0.84 (aOR: 1.33, 0.83–2.13), and WHR ≥ 0.85 (aOR: 1.05, 0.67–1.65) were not. Risk for CD was increased for women with elevated WHR and with higher BMI compared with normal. Conclusion WHR is not associated with LGA. While BMI performed better than WHR, neither was a strong predictor of LGA or need for CD in low-risk nulliparous women.

Original languageEnglish (US)
JournalAmerican Journal of Perinatology
DOIs
StateAccepted/In press - Oct 30 2015
Externally publishedYes

Fingerprint

Waist-Hip Ratio
Pregnancy Outcome
Body Mass Index
Obesity
Gestational Age
Odds Ratio
Pregnancy
Nomograms
Pre-Eclampsia
ROC Curve
Antioxidants
Logistic Models

Keywords

  • cesarean delivery
  • large-for-gestational age
  • obesity
  • waist-to-hip ratio

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Mcdonnold, M., Mele, L. M., Myatt, L., Hauth, J. C., Leveno, K. J., Reddy, U. M., & Mercer, B. M. (Accepted/In press). Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes. American Journal of Perinatology. https://doi.org/10.1055/s-0035-1569986

Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes. / Mcdonnold, Mollie; Mele, Lisa M.; Myatt, Leslie; Hauth, John C.; Leveno, Kenneth J.; Reddy, Uma M.; Mercer, Brian M.

In: American Journal of Perinatology, 30.10.2015.

Research output: Contribution to journalArticle

Mcdonnold, Mollie ; Mele, Lisa M. ; Myatt, Leslie ; Hauth, John C. ; Leveno, Kenneth J. ; Reddy, Uma M. ; Mercer, Brian M. / Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes. In: American Journal of Perinatology. 2015.
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title = "Waist-to-Hip Ratio versus Body Mass Index as Predictor of Obesity-Related Pregnancy Outcomes",
abstract = "Objective In nonpregnant populations the waist-to-hip ratio (WHR) is a better predictor of obesity-related outcomes than body mass index (BMI). Our objective was to determine, in pregnancy, the relationship between these measures of obesity, and large-for-gestational age (LGA) and cesarean delivery (CD). Methods This is a secondary analysis of data from the Combined Antioxidant and Preeclampsia Prediction Study. Women with a WHR of ≥ 0.85 and 0.80 to 0.84 at 9 to 16 weeks gestation were compared with those with a WHR <0.80. Women with early pregnancy BMI ≥ 30.0 kg/m2 (obese) and 25.0 to 29.9 kg/m2 (overweight) were compared with those <25.0 kg/m2. LGA was defined as > 90{\%} by Alexander nomogram. Univariable analysis, logistic regression, and receiver operating characteristic curves were used. Results Data from 2,276 women were analyzed. After correcting for potential confounders, only BMI ≥ 30 was significantly associated with LGA (adjusted odds ratio [aOR]: 2.07, 1.35–3.16) while BMI 25.0–29.9 (aOR: 1.5, 0.98–2.28), WHR 0.8–0.84 (aOR: 1.33, 0.83–2.13), and WHR ≥ 0.85 (aOR: 1.05, 0.67–1.65) were not. Risk for CD was increased for women with elevated WHR and with higher BMI compared with normal. Conclusion WHR is not associated with LGA. While BMI performed better than WHR, neither was a strong predictor of LGA or need for CD in low-risk nulliparous women.",
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AU - Myatt, Leslie

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AU - Leveno, Kenneth J.

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AU - Mercer, Brian M.

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N2 - Objective In nonpregnant populations the waist-to-hip ratio (WHR) is a better predictor of obesity-related outcomes than body mass index (BMI). Our objective was to determine, in pregnancy, the relationship between these measures of obesity, and large-for-gestational age (LGA) and cesarean delivery (CD). Methods This is a secondary analysis of data from the Combined Antioxidant and Preeclampsia Prediction Study. Women with a WHR of ≥ 0.85 and 0.80 to 0.84 at 9 to 16 weeks gestation were compared with those with a WHR <0.80. Women with early pregnancy BMI ≥ 30.0 kg/m2 (obese) and 25.0 to 29.9 kg/m2 (overweight) were compared with those <25.0 kg/m2. LGA was defined as > 90% by Alexander nomogram. Univariable analysis, logistic regression, and receiver operating characteristic curves were used. Results Data from 2,276 women were analyzed. After correcting for potential confounders, only BMI ≥ 30 was significantly associated with LGA (adjusted odds ratio [aOR]: 2.07, 1.35–3.16) while BMI 25.0–29.9 (aOR: 1.5, 0.98–2.28), WHR 0.8–0.84 (aOR: 1.33, 0.83–2.13), and WHR ≥ 0.85 (aOR: 1.05, 0.67–1.65) were not. Risk for CD was increased for women with elevated WHR and with higher BMI compared with normal. Conclusion WHR is not associated with LGA. While BMI performed better than WHR, neither was a strong predictor of LGA or need for CD in low-risk nulliparous women.

AB - Objective In nonpregnant populations the waist-to-hip ratio (WHR) is a better predictor of obesity-related outcomes than body mass index (BMI). Our objective was to determine, in pregnancy, the relationship between these measures of obesity, and large-for-gestational age (LGA) and cesarean delivery (CD). Methods This is a secondary analysis of data from the Combined Antioxidant and Preeclampsia Prediction Study. Women with a WHR of ≥ 0.85 and 0.80 to 0.84 at 9 to 16 weeks gestation were compared with those with a WHR <0.80. Women with early pregnancy BMI ≥ 30.0 kg/m2 (obese) and 25.0 to 29.9 kg/m2 (overweight) were compared with those <25.0 kg/m2. LGA was defined as > 90% by Alexander nomogram. Univariable analysis, logistic regression, and receiver operating characteristic curves were used. Results Data from 2,276 women were analyzed. After correcting for potential confounders, only BMI ≥ 30 was significantly associated with LGA (adjusted odds ratio [aOR]: 2.07, 1.35–3.16) while BMI 25.0–29.9 (aOR: 1.5, 0.98–2.28), WHR 0.8–0.84 (aOR: 1.33, 0.83–2.13), and WHR ≥ 0.85 (aOR: 1.05, 0.67–1.65) were not. Risk for CD was increased for women with elevated WHR and with higher BMI compared with normal. Conclusion WHR is not associated with LGA. While BMI performed better than WHR, neither was a strong predictor of LGA or need for CD in low-risk nulliparous women.

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KW - obesity

KW - waist-to-hip ratio

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