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Body mass index at age 18–20 and later risk of spontaneous abortion in the Health Examinees Study (HEXA)

Cited 10 time in Web of Science Cited 8 time in Scopus
Authors
Jung, Sun Jae; Park, Sue Kyung; Shin, Aesun; Lee, Sang-Ah; Choi, Ji-Yeob; Hong, Yun-Chul; Yoo, Keun-Young; Lee, Jong-Koo; Kang, Daehee
Issue Date
2015-09-24
Publisher
BioMed Central
Citation
BMC Pregnancy and Childbirth, 15(1):228
Description
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
Abstract
Background
Spontaneous abortion (SA) affects 11.2% of recognized pregnancies in Korea. Many studies have focused on the increased risk of SA in obese populations, but there are few studies that have focused on underweight (Body mass index (BMI) <18.5 kg/m2) women, especially in relation to pre-pregnancy BMI. The aim of this study was to examine the role of pre-pregnancy BMI at age 18–20 in later SA.

Methods
Among the women who were ever pregnant in the Health Examinees Study (HEXA), which was one of the cohorts studied in the KoGES (Korean Genome and Epidemiology Study) from 2004 to 2012 (N = 80,447), the likelihood of SA based on pre-pregnancy BMI, classified by the criteria for Asians (Underweight: <18.5 kg/m2; Normal range: 18.5-22.9 kg/m2; Overweight at risk: 23–24.9 kg/m2; Obese I: 25–29.9 kg/m2; Obese II: ≥30 kg/m2), was presented as odds ratios (ORs) and 95% confidence intervals (95% CIs) using logistic regression models.

Results
Being underweight or obese relative to the normal weight range was associated with a higher likelihood of SA (OR = 1.10 [95% CI = 1.05–1.15] in underweight women and OR = 1.06 [95% CI = 0.96–1.16] in obese women), and this effect was much greater in women who experienced recurrent SAs (for three or more SAs: OR = 1.29 [95% CI 1.14–1.46] in underweight women and OR = 1.39 [95% CI 1.09–1.78] in obese women). Obesity was associated with an increased likelihood of SA at a younger age (≤25 years), whereas underweight was associated with an increased OR of SA at an older age (≥26 years).

Discussion
As this study was conducted with baseline data of original cohort which focused on other chronic diseases, recall for previous pregnancy-related information might be less accurate. However, this study shows strength in its large size and prospective potential.

Conclusions
Pre-pregnancy BMI at ages 18–20 years revealed a U-shaped association with SA, and underweight and obese women showed increased likelihood for SA during different age periods.
Language
English
URI
http://hdl.handle.net/10371/100663
DOI
https://doi.org/10.1186/s12884-015-0665-2
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Biomedical Sciences (대학원 의과학과)Journal Papers (저널논문_의과학과)
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