Objective: To analyze the association between pre-pregnancy weight and pregnancy-related death. Study design: Population based, case-control with approval from the Institutional Review Board. This study utilizes a database of pregnancy-related deaths form North Carolina for a five-year period, 1992-1996 (n=128). For controls, a 0.5% random sample was taken from all live births for the same five year period in the State (n=2583). Pre-pregnancy weight was available for a subset of cases (n=46) and controls (n=1028) who were enrolled in the Women, Infants, and Children (WIC) supplemental nutrition program. The associations between pre-pregnancy weight and pregnancy-related death, pre-pregnancy weight and other risk factors for pregnancy-related death were explored with univariate analyses. Stepwise logistic regression was used to model the association between an outcome of pregnancy-related death and the predictive variables, pre-pregnancy weight, medical conditions, cesarean section, and maternal age. SAS software and a significance level of 0.05 were used for all analyses. Results: The mean pre-pregnancy weights (standard deviations) in lbs: Cases 171.2 (53.4) Controls 146 (39) Univariate analysis revealed a significant association between pre-pregnancy weight and pregnancy-related death, cesarean section, chronic hypertension, pregnancy-induced hypertension, diabetes, and maternal age. In the stepwise logistic regression model with pregnancy-related death as the dependent outcome, pre-pregnancy weight was no longer a significant risk factor after controlling for chronic hypertension, pregnancy-induced hypertension, cesarean section and maternal age. Conclusion: There is a significant association between pre-pregnancy weight and pregnancy-related death which is explained by advancing maternal age and increased rates of cesarean section and hypertensive disorders.
Learning Objectives: 1. List 5 risk factors for pregnancy-related death that are associated with higher pre-pregnancy weight. 2. Articulate possible mechanisms for the association between increasing pre-pregnancy weight and pregnancy-related death
Keywords: Maternal Health, Obesity
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.