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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.074294v1 97/1/157    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Smith, G. C.S. Articles by Dobbie, R. Search for Related Content PubMed PubMed Citation Articles by Smith, G. C.S. Articles by Dobbie, R. Related Collections Obesity, Overweight, Underweight Birth Outcomes Pregnancy Other Maternal and Infant Health

Gordon C.S. Smith, MD, PhD, Imran Shah, MSc, Jill P. Pell, MD, Jennifer A. Crossley, PhD and Richard Dobbie, BSc

At the time of the study, Gordon C.S. Smith and Imran Shah were with the Department of Obstetrics and Gynaecology, Cambridge University, Cambridge, England. At the time of the study, Imran Shah was with the Department of Obstetrics and Gynaecology, Cambridge University, and Jill P. Pell was with the Department of Public Health, Greater Glasgow, Glasgow, Scotland. Jennifer A. Crossley was with the Institute of Medical Genetics, Glasgow. Richard Dobbie was with the Information and Statistics Division, National Health Service for Scotland, Glasgow.

Correspondence: Requests for reprints should be sent to Gordon C.S. Smith, MD, PhD, Department of Obstetrics and Gynaecology, Cambridge University, Rosie Maternity Hospital, Cambridge CB2 2SW, United Kingdom (e-mail: gcss2{at}cam.ac.uk).

Objectives. We sought to determine the association between maternal body mass index and risk of preterm delivery.

Methods. We assessed 187 290 women in Scotland and estimated adjusted odds ratios for spontaneous and elective preterm deliveries among overweight, obese, and morbidly obese women relative to normal-weight women.

Results. Among nulliparous women, the risk of requiring an elective preterm delivery increased with increasing BMI, whereas the risk of spontaneous preterm labor decreased. Morbidly obese nulliparous women were at increased risk of all-cause preterm deliveries, neonatal death, and delivery of an infant weighing less than 1000 g who survived to 1 year of age (a proxy for severe long-term disability). By contrast, obesity and elective preterm delivery were only weakly associated among multiparous women.

Conclusions. Obese nulliparous women are at increased risk of elective preterm deliveries. This in turn leads to an increased risk of perinatal mortality and is likely to lead to increased risks of long-term disability among surviving offspring.

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