Validation of a Strict Obesity Definition Proposed for Asians to Predict Adverse Pregnancy Outcomes in Korean Pregnant Women
Authors
Seo-Yeon Kim ; Soo-Young Oh ; Ji-Hee Sung ; Suk-Joo Choi ; Cheong-Rae Roh ; Seung Mi Lee ; Jong Kwan Jun ; Mi-Young Lee ; JoonHo Lee ; Soo Hyun Kim ; Dong Hyun Cha ; You Jung Han ; Min Hyoung Kim ; Geum Joon Cho ; Han-Sung Kwon ; Byoung Jae Kim ; Mi Hye Park ; Hee Young Cho ; Hyun Sun Ko ; Jae-Yoon Shim ; Hyun Mee Ryu
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.36(44) : e281, 2021-11
Adult ; Asians ; Birth Weight ; Body Mass Index ; Cesarean Section / statistics & numerical data ; Diabetes, Gestational / diagnosis ; Diabetes, Gestational / etiology ; Female ; Gestational Age ; Humans ; Obesity / complications ; Obesity / pathology* ; Odds Ratio ; Pre-Eclampsia / diagnosis ; Pre-Eclampsia / etiology ; Pregnancy ; Pregnancy Outcome* ; Pregnant Women ; Premature Birth ; Republic of Korea ; Risk Factors
Keywords
Asian ; Maternal Obesity ; Neonatal ; Obesity ; Pregnancy
Abstract
Background: People are generally considered overweight and obese if their body mass index (BMI) is above 25 kg/m² and 30.0 kg/m², respectively. The World Health Organization proposed stricter criteria for Asians (≥ 23 kg/m²: overweight, ≥ 25 kg/m²: obese). We aimed to verify whether this criteria could predict adverse pregnancy outcomes in Korean women.
Methods: We included 7,547 Korean women from 12 institutions enrolled between June 2016 and October 2018. Women with no pre-pregnancy BMI data, not Korean, or lost to follow-up were excluded, leaving 6,331. The subjects were categorized into underweight, normal, overweight, class I obesity, and class II/III obesity based on a pre-pregnancy BMI of < 18.5, 18.5-22.9, 23.0-24.9, 25.0-29.9, and ≥ 30.0 kg/m², respectively.
Results: Overall, 13.4%, 63.0%, 11.8%, 9.1%, and 2.6% of women were underweight, normal, and overweight and had class I obesity and class II/III obesity, respectively. In the multivariable analysis adjusted for maternal age, a higher BMI significantly increased the risk of preeclampsia, gestational diabetes, preterm delivery caused by maternal-fetal indications, cesarean section, large for gestational age, and neonatal intensive care unit admission.
Conclusion: Adverse pregnancy outcomes started to increase in those with a pre-pregnancy BMI ≥ 23.0 kg/m² after adjusting for maternal age. The modified obesity criteria could help predict adverse pregnancy outcomes in Koreans.