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Am J Perinatol 2016; 33(06): 618-624
DOI: 10.1055/s-0035-1569986
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Mollie McDonnold
1   Department of Obstetrics and Gynecology, University of Texas Medical Center, Galveston, Texas
,
Lisa M. Mele
2   Biostatistics Center, The George Washington University, Washington, District of Columbia
,
Leslie Myatt
3   Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio
,
John C. Hauth
4   Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Kenneth J. Leveno
5   Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Uma M. Reddy
6   The Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Brian M. Mercer
7   Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio
,
for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units (MFMU) Network › Author Affiliations
Further Information

Publication History

14 October 2015

30 October 2015

Publication Date:
20 January 2016 (online)

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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.

Keywords

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

Note

This article was presented as a poster at The Society of Gynecologic Investigation Annual Meeting; March 20–23, 2013; Orlando, FL.


 

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