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 Shim; Hyun Mee Ryu

doi:10.3346/jkms.2021.36.e281

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

Department of Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

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, 18.5.22.9, 23.0.24.9, 25.0.29.9, 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 language	English
Article number	e281
Journal	Journal of Korean Medical Science
Volume	36
Issue number	44
DOIs	https://doi.org/10.3346/jkms.2021.36.e281
State	Published - Nov 2021

Bibliographical note

Funding Information:
Funding The original research of the Korean Perinatal Diagnosis Study was supported by a grant of the Korea Health Technology R&D Project at the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant No. HC15C1336). We thank Dr. Dong Wook Shin (Department of Family Medicine/Supportive Care Center, Samsung Medical Center and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University) and Kyunga Kim (1 Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea and Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea) for providing statistical advice.

Funding Information:
Diagnosis Study was supportProvisionaled by a grant Moreover, it was also found that Asians tend to have a higher body fat mass than non-of the Korea Health Technology R&D Project Asians within the same BMI groups.8 Therefore, the WHO proposed stricter criteria of the at the Korea Health Industry Development classification of obesity for Asians,9 which was adopted by the Korean Obesity Association & Welfare, Republic of Korea (grant No.Institute, funded by the Ministry of Health and Korean Diabetes Association in 201810,11: underweight (< 18.5 kg/m2), normal (18.5–22.9

Publisher Copyright:
© 2021. The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. All Rights Reserved.

Keywords

Asian
Maternal Obesity
Neonatal
Obesity
Pregnancy

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10.3346/jkms.2021.36.e281

Cite this

Kim, S. Y., Oh, S. Y., Sung, J. H., Choi, S. J., Roh, C. R., Lee, S. M., Jun, J. K., Lee, M. Y., Lee, J. H., Kim, S. H., Cha, D. H., Han, Y. J., Kim, M. H., Cho, G. J., Kwon, H. S., Kim, B. J., Park, M. H., Cho, H. Y., Ko, H. S., ... Ryu, H. M. (2021). Validation of a Strict Obesity Definition Proposed for Asian to Predict Adverse Pregnancy Outcomes in Korean Pregnant Women. Journal of Korean Medical Science, 36(44), Article e281. https://doi.org/10.3346/jkms.2021.36.e281

@article{3d2dd5f98a48478c8811b3eeee917979,

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

abstract = "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, 18.5.22.9, 23.0.24.9, 25.0.29.9, 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.",

keywords = "Asian, Maternal Obesity, Neonatal, Obesity, Pregnancy",

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

note = "Funding Information: Funding The original research of the Korean Perinatal Diagnosis Study was supported by a grant of the Korea Health Technology R&D Project at the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant No. HC15C1336). We thank Dr. Dong Wook Shin (Department of Family Medicine/Supportive Care Center, Samsung Medical Center and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University) and Kyunga Kim (1 Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea and Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea) for providing statistical advice. Funding Information: Diagnosis Study was supportProvisionaled by a grant Moreover, it was also found that Asians tend to have a higher body fat mass than non-of the Korea Health Technology R&D Project Asians within the same BMI groups.8 Therefore, the WHO proposed stricter criteria of the at the Korea Health Industry Development classification of obesity for Asians,9 which was adopted by the Korean Obesity Association & Welfare, Republic of Korea (grant No.Institute, funded by the Ministry of Health and Korean Diabetes Association in 201810,11: underweight (< 18.5 kg/m2), normal (18.5–22.9 Publisher Copyright: {\textcopyright} 2021. The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. All Rights Reserved.",

year = "2021",

month = nov,

doi = "10.3346/jkms.2021.36.e281",

language = "English",

volume = "36",

journal = "Journal of Korean Medical Science",

issn = "1011-8934",

publisher = "Korean Academy of Medical Science",

number = "44",

}

Kim, SY, Oh, SY, Sung, JH, Choi, SJ, Roh, CR, Lee, SM, Jun, JK, Lee, MY, Lee, JH, Kim, SH, Cha, DH, Han, YJ, Kim, MH, Cho, GJ, Kwon, HS, Kim, BJ, Park, MH, Cho, HY, Ko, HS, Shim, JY & Ryu, HM 2021, 'Validation of a Strict Obesity Definition Proposed for Asian to Predict Adverse Pregnancy Outcomes in Korean Pregnant Women', Journal of Korean Medical Science, vol. 36, no. 44, e281. https://doi.org/10.3346/jkms.2021.36.e281

TY - JOUR

T1 - Validation of a Strict Obesity Definition Proposed for Asian to Predict Adverse Pregnancy Outcomes in Korean Pregnant Women

AU - Kim, Seo Yeon

AU - Oh, Soo young

AU - Sung, Ji Hee

AU - Choi, Suk Joo

AU - Roh, Cheong Rae

AU - Lee, Seung Mi

AU - Jun, Jong Kwan

AU - Lee, Mi Young

AU - Lee, Joon Ho

AU - Kim, Soo Hyun

AU - Cha, Dong Hyun

AU - Han, You Jung

AU - Kim, Min Hyoung

AU - Cho, Geum Joon

AU - Kwon, Han Sung

AU - Kim, Byoung Jae

AU - Park, Mi Hye

AU - Cho, Hee Young

AU - Ko, Hyun Sun

AU - Shim, Jae Yoon

AU - Ryu, Hyun Mee

N1 - Funding Information: Funding The original research of the Korean Perinatal Diagnosis Study was supported by a grant of the Korea Health Technology R&D Project at the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant No. HC15C1336). We thank Dr. Dong Wook Shin (Department of Family Medicine/Supportive Care Center, Samsung Medical Center and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University) and Kyunga Kim (1 Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea and Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea) for providing statistical advice. Funding Information: Diagnosis Study was supportProvisionaled by a grant Moreover, it was also found that Asians tend to have a higher body fat mass than non-of the Korea Health Technology R&D Project Asians within the same BMI groups.8 Therefore, the WHO proposed stricter criteria of the at the Korea Health Industry Development classification of obesity for Asians,9 which was adopted by the Korean Obesity Association & Welfare, Republic of Korea (grant No.Institute, funded by the Ministry of Health and Korean Diabetes Association in 201810,11: underweight (< 18.5 kg/m2), normal (18.5–22.9 Publisher Copyright: © 2021. The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https:// creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. All Rights Reserved.

PY - 2021/11

Y1 - 2021/11

N2 - 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, 18.5.22.9, 23.0.24.9, 25.0.29.9, 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.

AB - 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, 18.5.22.9, 23.0.24.9, 25.0.29.9, 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.

KW - Asian

KW - Maternal Obesity

KW - Neonatal

KW - Obesity

KW - Pregnancy

UR - http://www.scopus.com/inward/record.url?scp=85118709910&partnerID=8YFLogxK

U2 - 10.3346/jkms.2021.36.e281

DO - 10.3346/jkms.2021.36.e281

M3 - Article

C2 - 34783214

AN - SCOPUS:85118709910

SN - 1011-8934

VL - 36

JO - Journal of Korean Medical Science

JF - Journal of Korean Medical Science

IS - 44

M1 - e281

ER -

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

Abstract

Bibliographical note

Keywords

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