{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T02:25:52Z","timestamp":1773973552666,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,3,3]],"date-time":"2014-03-03T00:00:00Z","timestamp":1393804800000},"content-version":"vor","delay-in-days":61,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NICHD","award":["1R01HD049819-01A2"],"award-info":[{"award-number":["1R01HD049819-01A2"]}]},{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Center for Advancing Translational Sciences of the National Institutes of Health through","award":["8UL1TR000041"],"award-info":[{"award-number":["8UL1TR000041"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The purpose of this study was to explore the impact of body mass index (BMI) or pregnancy weight gain on the presence, site, and severity of genital tract trauma at childbirth in nulliparous women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study is a subanalysis of a prospective cohort of healthy nulliparous women recruited during pregnancy and followed through birth. Weight gain during pregnancy and prepregnancy BMI were recorded. At birth, women underwent detailed mapping of genital tract trauma. For analyses, women were dichotomized into obese (BMI\u00a0\u2265\u00a030) versus nonobese (BMI\u00a0&lt;\u00a030) at baseline as well as into those who gained weight as recommended by the Institute of Medicine (IOM) and those who gained more than the recommended amount to determine the impact of obesity or excessive weight gain on rates of genital tract trauma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 445 women were available for analysis. Presence and severity of genital tract trauma did not vary between obese and nonobese women (51% vs 53%, <jats:italic>P<\/jats:italic>\u00a0= .64). Likewise, women who had more than the IOM\u2010recommended weight gain did not have a higher incidence of perineal lacerations (52% versus 53% with perineal lacerations, <jats:italic>P\u00a0<\/jats:italic>= .69). Obese women were more likely to gain in excess of the IOM guidelines during pregnancy (75% vs 50% excessive weight gain in obese vs nonobese women, respectively; <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>A woman's BMI or excessive weight gain in pregnancy did not influence her risk of genital tract trauma at birth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.12114","type":"journal-article","created":{"date-parts":[[2014,3,3]],"date-time":"2014-03-03T19:09:34Z","timestamp":1393873774000},"page":"54-59","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Impact of Nulliparous Women's Body Mass Index or Excessive Weight Gain in Pregnancy on Genital Tract Trauma at Birth"],"prefix":"10.1111","volume":"59","author":[{"given":"Kelly","family":"Gallagher","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Migliaccio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca G.","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Leeman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Hervey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clifford","family":"Qualls","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.39"},{"key":"e_1_2_6_3_1","volume-title":"Prevalence of Obesity in the United States, 2009\u20132010","author":"Ogden CL","year":"2012"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2007.149"},{"key":"e_1_2_6_5_1","first-page":"436","article-title":"Pregnancy complications and outcomes among overweight and obese nulliparous women","author":"Baeten J","year":"2001","journal-title":"Am J Public Health"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182245d49"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2009.00355.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.547"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2008.05.010"},{"issue":"12","key":"e_1_2_6_10_1","first-page":"CD006672","article-title":"Perineal techniques during the second stage of labour for reducing perineal trauma","author":"Aasheim V","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/939762"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820afaf2"},{"key":"e_1_2_6_13_1","volume-title":"Weight Gain During Pregnancy","author":"Institute of Medicine, Committee to Reexamine IOM Pregnancy Weight Guidelines","year":"2009"},{"key":"e_1_2_6_14_1","volume-title":"Outcomes of Maternal Weight Gain, Evidence Report\/Technology Assessment No. 168","author":"Viswanathan M","year":"2008"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1110088"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2006.03.001"},{"key":"e_1_2_6_17_1","first-page":"928","volume":"191","author":"Kabiru W","year":"2004","journal-title":"Obstetric outcomes associated with increase in BMI category during pregnancy"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.116095"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-007-0373-1"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2005.05.012"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2011.02.018"}],"container-title":["Journal of Midwifery &amp; 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