Self-reported Pre-pregnancy Weight Versus Weight Measured at First Prenatal Visit: Effects on Categorization of Pre-preg
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Self-reported Pre-pregnancy Weight Versus Weight Measured at First Prenatal Visit: Effects on Categorization of Pre-pregnancy Body Mass Index Erica Holland • Tiffany A. Moore Simas Darrah K. Doyle Curiale • Xun Liao • Molly E. Waring
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Ó Springer Science+Business Media New York 2012
Abstract To compare classification of pre-pregnancy body mass index (BMI) using self-reported pre-pregnancy weight versus weight measured at the first prenatal visit. Retrospective cohort of 307 women receiving prenatal care at the faculty and resident obstetric clinics at a Massachusetts tertiary-care center. Eligible women initiated prenatal care prior to 14 weeks gestation and delivered singleton infants between April 2007 and March 2008. On average, self-reported weight was 4 pounds lighter than measured weight at the first prenatal visit (SD 7.2 pounds; E. Holland T. A. Moore Simas X. Liao Department of Obstetrics and Gynecology, University of Massachusetts Medical School/University of Massachusetts Memorial Health Care, 119 Belmont Street, Jaquith Building, Worcester, MA 01605, USA e-mail: [email protected] T. A. Moore Simas e-mail: [email protected] X. Liao e-mail: [email protected] T. A. Moore Simas Department of Pediatrics, University of Massachusetts Medical School/University of Massachusetts Memorial Health Care, Worcester, MA 01605, USA D. K. Doyle Curiale Department of Obstetrics, Gynecology, and Reproductive Sciences Residency, Yale School of Medicine, PO Box 208063, New Haven, CT 06520-8063, USA e-mail: [email protected] M. E. Waring (&) Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, ACCES7, Worcester, MA 01655, USA e-mail: [email protected]
range: 19 pounds lighter to 35 pounds heavier). Using selfreported pre-pregnancy weight to calculate pre-pregnancy BMI, 4.2 % of women were underweight, 48.9 % were normal weight, 25.4 % were overweight, and 21.5 % were obese. Using weight measured at first prenatal visit, these were 3.6, 45.3, 26.4, and 24.8 %, respectively. Classification of pre-pregnancy BMI was concordant for 87 % of women (weighted kappa = 0.86; 95 % CI 0.81–0.90). Women gained an average of 32.1 pounds (SD 18.0 pounds) during pregnancy. Of the 13 % of the sample with discrepant BMI classification, 74 % gained within the same adherence category when comparing weight gain to Institute of Medicine recommendations. For the vast majority of women, self-reported pre-pregnancy weight and measured weight at first prenatal visit resulted in identical classification of pre-pregnancy BMI. In absence of measured prepregnancy weight, we recommend that providers calculate both values and discuss discrepancies with their pregnant patients, as significant weight loss or gain during the first trimester may indicate a need for additional oversight with potential intervention. Keywords Gestational weight gain Pre-pregnancy BMI Self-re
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