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B ody M ass I ndex and Pregnancy Outcome:

B ody M ass I ndex and Pregnancy Outcome:. Results from the revised birth certificate. Sharon Kirmeyer, Ph.D. Statistician/Demographer, Division of Vital Statistics National Center for Health Statistics, Centers for Disease Control and Prevention.

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B ody M ass I ndex and Pregnancy Outcome:

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  1. Body Mass Index and Pregnancy Outcome: Results from the revised birth certificate Sharon Kirmeyer, Ph.D.Statistician/Demographer, Division of Vital StatisticsNational Center for Health Statistics, Centers for Disease Control and Prevention James RubertoneStatistician, Bureau of Health Statistics and ResearchPennsylvania Department of Health

  2. Introduction • Presenting findings on Body Mass Index and pregnancy outcome, using new data from revised certificate • Historically, concern with underweight mothers and pregnancy outcome • Recently, concern also with overweight and obesity and pregnancy outcome

  3. Obesity trends • Maps show why there is concern with obesity in U.S. • Increase in adult obesity in 20 years: from being essentially non-existent to a prevalence of >25 % in half of states • Example of obese woman= 5’4” and at least 30 pounds overweight

  4. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1985

  5. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1986

  6. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1987

  7. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1988

  8. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1989

  9. No Data <10% 10%–14% Obesity Trends* Among U.S. AdultsBRFSS, 1990

  10. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1991

  11. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1992

  12. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1993

  13. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1994

  14. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1995

  15. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1996

  16. No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends* Among U.S. AdultsBRFSS, 1997

  17. No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends* Among U.S. AdultsBRFSS, 1998

  18. No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends* Among U.S. AdultsBRFSS, 1999

  19. No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends* Among U.S. AdultsBRFSS, 2000

  20. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. AdultsBRFSS, 2001

  21. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. AdultsBRFSS, 2002

  22. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. AdultsBRFSS, 2003

  23. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. AdultsBRFSS, 2004

  24. No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. AdultsBRFSS, 2005

  25. No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. AdultsBRFSS, 2006

  26. What Is Body Mass Index? • Based upon height and weight Formula: BMI = Weight (lb) / [height (in)]2 x 703 • Does not measure fat directly • Used to identify possible weight problems

  27. Methods • 18 states collected 2006 data using revised birth certificate with mother’s height and weight data • Limited to singleton births (approx. 95% of all births) • Excluded records which did not have mother’s height or weight • Total 1.4 million births NOTE: All 2006 data considered preliminary

  28. Selected New Items on 2003 Certificate

  29. WA ME MT ND MN VT OR NH MA ID WI NY SD CT WY MI RI PA IA NJ NE NV OH DE IN IL UT DC MD CO WV VA KS MO CA KY NC TN OK AZ AR SC NM 2003 to 2006 GA AL MS TX 2007 or later LA FL AK Does not report height and weight HI States Using Revised Birth Certificate in 2006 NOTE: New York State, but not New York City

  30. BMI Category Definitions SOURCE: National Heart, Lung, and Blood Institute (1998).

  31. Average Overweight Obese Underweight BMI distribution of Mothers18 State Reporting Area - 2006 (preliminary)

  32. Distribution of Mothers by BMI Category18 State Reporting Area - 2006 (preliminary) -- Obese Overweight -- -- Underweight -- Average

  33. Obese Overweight Average Underweight BMI Distribution by Race of Mother18 State Reporting Area - 2006 (preliminary) NH=Non-Hispanic AI/AN=American Indian/Alaska Native A/PI=Asian/Pacific Islander

  34. Percent Preterm and Low Birthweight Infants by BMI Category18 State Reporting Area - 2006 (preliminary) Preterm Low Birthweight

  35. Percent Very Preterm and Very Birthweight by BMI Category18 State Reporting Area – 2006 (preliminary) Very Preterm Very Low Birthweight percent

  36. % 4000+ Gram Infants and Mother’s Pre-pregnancy Diabetes Status 4000+ g. infant /No pre-pregnancy diabetes 4000+ g. infant / With pre-pregnancy diabetes percent Percent of Women with 4000+ Gram Infants by BMI Category18 State Reporting Area - 2006 (preliminary) % 4000+ Gram Infants percent

  37. Gestational Diabetes/Hypertension by BMI Category18 State Reporting Area – 2006 (preliminary) Gestational Diabetes Gestational Hypertension

  38. Breech Fetal Presentation by BMI Category18 State Reporting Area – 2006 (preliminary) // 0.0

  39. Cesarean Delivery by BMI Category18 State Reporting Area – 2006 (preliminary)

  40. Unplanned Procedure Rates // 0.0 Unplanned Procedures by BMI Category18 State Reporting Area – 2006 (preliminary)

  41. Average Pre-Pregnancy Weight Gain by BMI Category18 State Reporting Area - 2006 (preliminary) Underweight Average Overweight Obese // 0

  42. Average Pre-Pregnancy Weight Gain by BMI Category and Race/Ethnicity18 State Reporting Area - 2006 (preliminary) Non-Hispanic White Underweight Non-Hispanic Black Hispanic Average Overweight Obese // 0

  43. Summary • ½ women with singleton live births in 2006 reporting area were overweight or obese • Black and AI/AN women more likely to be obese • Risk of preterm and low birthweight elevated for infants of underweight mothers • Risk of giving birth to macrosomic (4000+ g.) infant elevated for obese women • Rates of many pregnancy risk factors, complications in delivery, and C-sections higher for obese women

  44. Conclusion • New BMI data are very useful to show associations with maternal-infant outcomes • Can translate findings into prepregnancy practice • Slides demonstrate power of states and federal DVS working together • We look forward to working together on a paper giving more detail on this topic

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