Pregnancy, obesity, gestational weight gain, and parity as predictors of peripartum complications

Abstract

Purpose: To determine if the best predictor of pregnancy complications is pre-pregnancy body mass index (BMI) alone or in combination with other factors.

Methods: BMI and peripartum outcomes of singleton pregnancies were evaluated. Recursive partitioning and logistic regression modeling was used.

Results: Of the 4,286 cohorts, 26% were obese (BMI >30 kg/m(2)) and, compared to cohorts with normal weight, at risk for wound infections (P < 0.001), and shoulder dystocia (P < 0.001). High-risk patients (15%; BMI >32.5, parity, pregnancy weight gain of 28 lb by 28 weeks) were at increased risk for wound infection (P < 0.001), endometritis (P < 0.001), shoulder dystocia (P = 0.001) and 5 min Apgar score <4 (P < 0.041) and at lower risk for pre-term delivery (P = 0.007).

Conclusions: Since BMI, parity, and weight gain until 28 weeks together provide better prediction of peripartum complications than BMI alone, these characteristics can be used to triage and refer patients.