Statistical modeling of the relationship between pre-pregnancy body-mass-index and maternal and perinatal outcomes
department or school: Medicine, Faculty of
department or school: Obstetrics and Gynaecology, Department of
data provider: DSpace
degree campus: UBCV
creator: Bone, Jeffrey
issued: 2024-12-23T21:48:53Z
issued: 2024
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: Background: High pre-pregnancy body-mass-index (BMI) is an important risk factor for adverse maternal and perinatal outcomes. However, there are knowledge gaps regarding the association between high BMI and adverse birth outcomes, including the interrelationship between BMI and other risk factors for adverse pregnancy outcomes and how the risk associated with BMI may vary across gestational age. Methods: I used population-based data on live births and stillbirths from British Columbia, Canada (British Columbia Perinatal Database Registry, 2000-2022) and the United States (National Center for Health Statistics, 2016-2017). I examined whether earlier delivery explained the association between obesity and perinatal death. Possible heterogeneity in the association between BMI and adverse maternal and perinatal outcomes in women with chronic hypertension and diabetes mellitus, was quantified both overall and by gestational week. Further analyzed was the relationship between obesity and twinning, and adverse pregnancy outcomes in twin pregnancies. Results: The study population in British Columbia included live births and stillbirths to 524,845 women who delivered from 2000 to 2022. The prevalence of pre-pregnancy obesity among these women was 13%. Preterm delivery explained 63% of the association between obesity and the higher rates of perinatal death. Additionally, increasing pre-pregnancy BMI was associated with higher rates of twinning, which was partially explained by increased use of invitro fertilization. However, in contrast to singleton pregnancies, pre-pregnancy obesity was not associated with adverse pregnancy outcomes in twin pregnancies. Studies utilizing US data included 7,576,417 pregnancies, with a prevalence of pre-pregnancy obesity of 26.4%. Comorbid chronic hypertension or pre-pregnancy diabetes modified the relationship between obesity and adverse perinatal outcomes: obese women without these chronic conditions had a higher relative risk of adverse peri…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/89984
note: Statistical modeling of the relationship between pre-pregnancy body-mass-index and maternal and perinatal outcomes by Jeffrey Bone MSc., Statistics, The University of British Columbia, 2016 BSc Honours., Mathematics and Statistics, The University of Victoria, 2014 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in The Faculty of Graduate and Postdoctoral Studies (Women+ and Children’s Health Sciences) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) December 2024 © Jeffrey Bone, 2024 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled: Statistical modeling of the relationship between pre-pregnancy body-mass-index and maternal and perinatal outcomes submitted by Jeffrey Bone in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Women+ and Children’s Health Sciences Examining Committee: Sarka Lisonkova, Associate Professor, Department of Obstetrics and Gynecology, UBC Supervisor KS Joseph, Professor, Department of Obstetrics and Gynecology, UBC Supervisory Committee Member Laura Magee, Professor, School of Life Course Sciences, King’s College London Supervisory Committee Member Geoffrey Cundiff, Professor, Department of Obstetrics and Gynecology, UBC University Examiner Jason Sutherland, Professor, School of Population and Public Health, UBC University Examiner Additional Supervisory Committee Members: Chantal Mayer, Clinical Associate Professor, Department of Obstetrics and Gynecology, UBC Supervisory Committee Member iii Abstract Background: High pre-pregnancy body-mass-index (BMI) is an important risk factor for adverse maternal and perinatal outcomes. However, there are knowledge gaps regarding the association between high BMI and adverse birth outcomes, including the interrelationship between BMI and other risk factors for adverse pregnancy outcomes and how the risk assoc…
has type: Thesis/Dissertation
date issued: 2025-05
is shown at: 10.14288/1.0447607
language: eng
degree discipline: Women+ and Children’s Health Sciences
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Lisonkova, Sarka
type: Text
identifier URI: http://hdl.handle.net/2429/89984