Validation of a Strict Obesity Definition Proposed for Asian to Predict Adverse Pregnancy Outcomes in Korean Pregnant Women

Seo Yeon Kim, Soo young Oh, Ji Hee Sung, Suk Joo Choi, Cheong Rae Roh, Seung Mi Lee, Jong Kwan Jun, Mi Young Lee, Joon Ho Lee, Soo Hyun Kim, Dong Hyun Cha, You Jung Han, Min Hyoung Kim, Geum Joon Cho, Han Sung Kwon, Byoung Jae Kim, Mi Hye Park, Hee Young Cho, Hyun Sun Ko, Jae Yoon ShimHyun Mee Ryu

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Background: People are considered overweight and obese if their body mass index (BMI) is above 25 kg/m2 and 30.0 kg/m2, respectively. The World Health Organization proposed stricter criteria for Asians (≥ 23 kg/m2: overweight, ≥ 25 kg/m2: obese). We aimed to verify whether this criteria could predict adverse pregnancy outcomes in Korean women. Methods: We included 7,547 Korean women from 12 institutions between June 2016 and October 2018. Women with no pre-pregnancy BMI data, not Korean, or lost to follow-up were excluded, leaving 6,331. The subjects were categorized into underweight, normal, overweight, class I obesity, and class II/III obesity based on a pre-pregnancy BMI of < 18.5,,,, and ≥ 30.0 kg/m2, respectively. Results: Overall, 13.4%, 63.0%, 11.8%, 9.1%, and 2.6% of women were underweight, normal, and overweight and had class I obesity and class II/III obesity, respectively. In the multivariable analysis adjusted for maternal age, a higher BMI significantly increased the risk of preeclampsia, gestational diabetes, preterm delivery caused by maternal-fetal indications, cesarean section, large for gestational age, and neonatal intensive care unit admission. Conclusion: Adverse pregnancy outcomes increased in those with a pre-pregnancy BMI ≥ 23.0 kg/m2 after adjusting for maternal age. The modified obesity criteria could help predict adverse pregnancy outcomes in Koreans.

Original languageEnglish
Article numbere281
JournalJournal of Korean Medical Science
Issue number44
StatePublished - Nov 2021


  • Asian
  • Maternal Obesity
  • Neonatal
  • Obesity
  • Pregnancy


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