{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:26:51Z","timestamp":1781875611477,"version":"3.54.5"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,10,15]],"date-time":"2015-10-15T00:00:00Z","timestamp":1444867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pre\u2010pregnancy body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>) and gestational weight gain (<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>) are reported to impact the preterm birth (<jats:styled-content style=\"fixed-case\">PTB<\/jats:styled-content>) rate and newborn size. Most studies have been conducted in developed countries, although<jats:styled-content style=\"fixed-case\">PTB<\/jats:styled-content>and adverse pregnancy outcomes are more frequent in the developing world. The aim of this study is to elucidate the association of pre\u2010pregnancy<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>on the occurrence of<jats:styled-content style=\"fixed-case\">PTB<\/jats:styled-content>and sub\u2010optimal fetal size in<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>ebanon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective cohort study using a hospital\u2010based register covering 35% of births in<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>ebanon between 2001 and 2012. Data were collected on 170\u2009428 pregnancies from 32 hospitals using medical records and interviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After adjusting for confounders, underweight women had increased odds of having very preterm [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 1.58, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.16, 2.14], preterm (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>1.42, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.28, 1.58), and small for gestational age (<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>1.50, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.37, 1.63) neonates. When<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>was analysed with<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>, only<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>remained significant in underweight women with low<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>. For all<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>groups, low<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>was protective against large for gestational age (<jats:styled-content style=\"fixed-case\">LGA<\/jats:styled-content>) and high<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>increased the odds of<jats:styled-content style=\"fixed-case\">LGA<\/jats:styled-content>.<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>, both low (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>1.25, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.15, 1.35) and high (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>1.43, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.32, 1.55) increased the risk of<jats:styled-content style=\"fixed-case\">PTB<\/jats:styled-content>in normal weight women. The same result was obtained for overweight women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>increased the risk of<jats:styled-content style=\"fixed-case\">LGA<\/jats:styled-content>for all groups and<jats:styled-content style=\"fixed-case\">PTB<\/jats:styled-content>in normal weight and overweight women, whereas low<jats:styled-content style=\"fixed-case\">GWG<\/jats:styled-content>increased the risk of<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">PTB<\/jats:styled-content>. Given that there are not many studies from middle income\/developing countries on patterns of weight gain during pregnancy, findings from this study may help with pre\u2010conception counselling with emphasis on the importance of an optimal pre\u2010pregnancy<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>and appropriate weight gain during pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12249","type":"journal-article","created":{"date-parts":[[2015,10,15]],"date-time":"2015-10-15T17:42:41Z","timestamp":1444930961000},"page":"38-45","source":"Crossref","is-referenced-by-count":41,"title":["Association of Pre\u2010Pregnancy Body Mass Index and Gestational Weight Gain with Preterm Births and Fetal Size: an Observational Study from<scp>L<\/scp>ebanon"],"prefix":"10.1111","volume":"30","author":[{"given":"Rym","family":"El Rafei","sequence":"first","affiliation":[{"name":"Pediatrics and Adolescent Medicine Neonatology American University of Beirut Medical Center 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