{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:09:43Z","timestamp":1787504983114,"version":"build-2736575974"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000380","name":"Guy's and St Thomas' Charity","doi-asserted-by":"publisher","award":["ISA180105"],"award-info":[{"award-number":["ISA180105"]}],"id":[{"id":"10.13039\/501100000380","id-type":"DOI","asserted-by":"publisher"}]},{"name":"CAPES Brazil","award":["BEX 9571\/13-2"],"award-info":[{"award-number":["BEX 9571\/13-2"]}]},{"DOI":"10.13039\/501100000306","name":"Tommy's Baby Charity","doi-asserted-by":"publisher","award":["N\/A - London support centre"],"award-info":[{"award-number":["N\/A - London support centre"]}],"id":[{"id":"10.13039\/501100000306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MFM-146444"],"award-info":[{"award-number":["MFM-146444"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN-148438"],"award-info":[{"award-number":["FDN-148438"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Approximately one in five pregnant women have obesity. Obesity is associated with an increased risk of antenatal, intrapartum, and perinatal complications, but many women with obesity have uncomplicated pregnancies. At a time where maternity services are advocating for women to make informed choices, knowledge of the chance of having an uncomplicated (healthy) pregnancy is essential. The objective of this study was to calculate the rate of uncomplicated pregnancy in women with obesity and evaluate factors associated with this outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study was conducted using the Ontario birth registry dataset in Canada (703,115 women, April 2012\u2013March 2017). The rate of uncomplicated or complicated composite pregnancy outcomes (hypertensive disorders of pregnancy, gestational diabetes, preterm birth, neonate small- or large- for gestational age at birth, congenital anomaly, fetal death, antepartum bleeding or preterm prelabour membrane rupture) were calculated for women with and without obesity. Associations between uncomplicated pregnancy and maternal characteristics were explored in a population of women with obesity but without other pre-existing co-morbidities (e.g., essential hypertension) or obstetric risks identified in the first trimester (e.g., multiple pregnancy), using log binomial regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the studied Ontario maternity population (body mass index not missing) 17\u00b77% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009117,236) were obese. Of these 20\u00b76% had pre-existing co-morbidities or early obstetric complicating factors. Amongst women with obesity but without early complicating factors, 58\u00b72% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200954,191) experienced pregnancy without complication; this is in comparison to 72\u00b77% of women of healthy weight and no early complicating factors. Women with obesity and no early pregnancy complicating factors are more likely to have an uncomplicated pregnancy if they are multiparous, younger, more affluent, of White or Black ethnicity, of lower weight, with normal placental-associated plasma protein-A and\/or spontaneously conceived pregnancies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study demonstrates that over half of women with obesity but no other pre-existing medical or early obstetric complicating factors, proceed through pregnancy without adverse obstetric complication. Care in lower-risk settings can be considered as their outcomes appear similar to those reported for low-risk nulliparous women. Further research and predictive tools are needed to inform stratification of women with obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-021-03663-2","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T03:03:33Z","timestamp":1614913413000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Characteristics associated with uncomplicated pregnancies in women with obesity: a population-based cohort study"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2007-9647","authenticated-orcid":false,"given":"Sophie","family":"Relph","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfang","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alysha L. J.","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matias C.","family":"Vieira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Corsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M.","family":"Gaudet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharmintra","family":"Pasupathy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,5]]},"reference":[{"key":"3663_CR1","unstructured":"2014\u20132014 biennial report - facts from Ontario [http:\/\/www.bornontario.ca\/en\/about-born\/governance\/annual-reports\/2014-2016-annual-report\/facts-from-ontario\/] Accessed 29 Sept 2020."},{"issue":"12","key":"3663_CR2","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1016\/S2213-8587(16)30217-0","volume":"4","author":"L Poston","year":"2016","unstructured":"Poston L, Caleyachetty R, Cnattingius S, Corvalan C, Uauy R, Herring S, Gillman MW. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol. 2016;4(12):1025\u201336.","journal-title":"Lancet Diabetes Endocrinol"},{"key":"3663_CR3","unstructured":"National maternity and perinatal audit: clinical report 2019. Based on births in NHS maternity services between 1 April 2016 and 31 March 2017. [https:\/\/maternityaudit.org.uk\/pages\/reports] Accessed 18 Dec 2020."},{"issue":"3","key":"3663_CR4","doi-asserted-by":"publisher","first-page":"e62","DOI":"10.1111\/1471-0528.15386","volume":"126","author":"FC Denison","year":"2019","unstructured":"Denison FC, Aedla NR, Keag O, Hor K, Reynolds RM, Milne A, Diamond A, Royal College of O, Gynaecologists. Care of women with obesity in pregnancy: green-top guideline no. 72. BJOG. 2019;126(3):e62\u2013e106.","journal-title":"BJOG"},{"issue":"3","key":"3663_CR5","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1111\/1471-0528.12437","volume":"121","author":"J Hollowell","year":"2014","unstructured":"Hollowell J, Pillas D, Rowe R, Linsell L, Knight M, Brocklehurst P. The impact of maternal obesity on intrapartum outcomes in otherwise low risk women: secondary analysis of the birthplace national prospective cohort study. BJOG. 2014;121(3):343\u201355.","journal-title":"BJOG"},{"key":"3663_CR6","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1111\/1471-0528.12684","volume":"121","author":"D Deemers","year":"2014","unstructured":"Deemers D, Wijnen H, van Limbeek E, Bude L, Nieuwenhuijze M, Spaanderman M, de Vries R. The impact of obesity on outcomes of midwife-led pregnancy and childbirth in a primary care population: a prospective cohort study. BJOG. 2014;121:1403\u201314.","journal-title":"BJOG"},{"issue":"1","key":"3663_CR7","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1186\/s12916-017-0956-8","volume":"15","author":"MC Vieira","year":"2017","unstructured":"Vieira MC, White SL, Patel N, Seed PT, Briley AL, Sandall J, Welsh P, Sattar N, Nelson SM, Lawlor DA, et al. Prediction of uncomplicated pregnancies in obese women: a prospective multicentre study. BMC Med. 2017;15(1):194.","journal-title":"BMC Med"},{"key":"3663_CR8","unstructured":"Informed decision-making for labour & birth [https:\/\/opha.on.ca\/Position-Papers\/Informed-Decision-Making-for-Labour-and-Birth-v-2.aspx] Accessed 18 Dec 2020."},{"key":"3663_CR9","unstructured":"Better Births: Improving outcomes of maternity services in England. [https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2016\/02\/national-maternity-review-report.pdf? PDFPATHWAY=PDF] Accessed 18 Dec 2020."},{"issue":"1","key":"3663_CR10","doi-asserted-by":"publisher","first-page":"e0227325","DOI":"10.1371\/journal.pone.0227325","volume":"15","author":"S Relph","year":"2020","unstructured":"Relph S, Ong M, Vieira MC, Pasupathy D, Sandall J. Perceptions of risk and influences of choice in pregnant women with obesity. An evidence synthesis of qualitative research. PLoS One. 2020;15(1):e0227325.","journal-title":"PLoS One"},{"key":"3663_CR11","doi-asserted-by":"publisher","first-page":"i555","DOI":"10.1136\/bmj.i555","volume":"352","author":"L Cheikh Ismail","year":"2016","unstructured":"Cheikh Ismail L, Bishop DC, Pang R, Ohuma EO, Kac G, Abrams B, Rasmussen K, Barros FC, Hirst JE, Lambert A, et al. Gestational weight gain standards based on women enrolled in the fetal growth longitudinal study of the INTERGROWTH-21st project: a prospective longitudinal cohort study. BMJ. 2016;352:i555.","journal-title":"BMJ"},{"key":"3663_CR12","unstructured":"Obesity: preventing and managing the global epidemic. Report on a WHO Consultation on Obesity, Geneva, 3\u20135 June, 1997 [https:\/\/apps.who.int\/iris\/handle\/10665\/63854] Accessed 18 Dec 2020."},{"key":"3663_CR13","unstructured":"Statistics Canada. Health characteristics, annual estimates [https:\/\/www150.statcan.gc.ca\/t1\/tbl1\/en\/tv.action?pid=1310009601]. Accessed 29 Sept 2020."},{"issue":"10","key":"3663_CR14","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1111\/obr.12570","volume":"18","author":"E Robinson","year":"2017","unstructured":"Robinson E. Overweight but unseen: a review of the underestimation of weight status and a visual normalization theory. Obes Rev. 2017;18(10):1200\u20139.","journal-title":"Obes Rev"},{"issue":"9","key":"3663_CR15","doi-asserted-by":"publisher","first-page":"185","DOI":"10.24095\/hpcdp.36.9.02","volume":"36","author":"S Dzakpasu","year":"2016","unstructured":"Dzakpasu S, Duggan J, Fahey J, Kirby RS. Estimating bias in derived body mass index in the Maternity experiences survey. Health Promot Chronic Dis Prev Can. 2016;36(9):185\u201393.","journal-title":"Health Promot Chronic Dis Prev Can"},{"issue":"1","key":"3663_CR16","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/s12884-016-0983-z","volume":"16","author":"BK Natamba","year":"2016","unstructured":"Natamba BK, Sanchez SE, Gelaye B, Williams MA. Concordance between self-reported pre-pregnancy body mass index (BMI) and BMI measured at the first prenatal study contact. BMC Pregnancy Childbirth. 2016;16(1):187.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"7","key":"3663_CR17","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1007\/s10995-017-2266-3","volume":"21","author":"AL Bannon","year":"2017","unstructured":"Bannon AL, Waring ME, Leung K, Masiero JV, Stone JM, Scannell EC, Moore Simas TA. Comparison of self-reported and measured pre-pregnancy weight: implications for gestational weight gain counseling. Matern Child Health J. 2017;21(7):1469\u201378.","journal-title":"Matern Child Health J"},{"issue":"10","key":"3663_CR18","doi-asserted-by":"publisher","first-page":"1872","DOI":"10.1007\/s10995-012-1210-9","volume":"17","author":"E Holland","year":"2013","unstructured":"Holland E, Moore Simas TA, Doyle Curiale DK, Liao X, Waring ME. Self-reported pre-pregnancy weight versus weight measured at first prenatal visit: effects on categorization of pre-pregnancy body mass index. Matern Child Health J. 2013;17(10):1872\u20138.","journal-title":"Matern Child Health J"},{"issue":"8","key":"3663_CR19","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1111\/1471-0528.15664","volume":"126","author":"U Sovio","year":"2019","unstructured":"Sovio U, Smith G. Evaluation of a simple risk score to predict preterm pre-eclampsia using maternal characteristics: a prospective cohort study. BJOG. 2019;126(8):963\u201370.","journal-title":"BJOG"},{"issue":"3","key":"3663_CR20","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1161\/HYPERTENSIONAHA.114.03578","volume":"64","author":"LC Kenny","year":"2014","unstructured":"Kenny LC, Black MA, Poston L, Taylor R, Myers JE, Baker PN, McCowan LM, Simpson NA, Dekker GA, Roberts CT, et al. Early pregnancy prediction of preeclampsia in nulliparous women, combining clinical risk and biomarkers: the screening for pregnancy endpoints (SCOPE) international cohort study. Hypertension. 2014;64(3):644\u201352.","journal-title":"Hypertension"},{"issue":"2","key":"3663_CR21","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1002\/oby.21715","volume":"25","author":"MC Vieira","year":"2017","unstructured":"Vieira MC, Poston L, Fyfe E, Gillett A, Kenny LC, Roberts CT, Baker PN, Myers JE, Walker JJ, McCowan LM, et al. Clinical and biochemical factors associated with preeclampsia in women with obesity. Obesity (Silver Spring). 2017;25(2):460\u20137.","journal-title":"Obesity (Silver Spring)"},{"issue":"f6398","key":"3663_CR22","doi-asserted-by":"publisher","first-page":"f6398","DOI":"10.1136\/bmj.f6398","volume":"347","author":"LC Chappell","year":"2013","unstructured":"Chappell LC, Seed PT, Myers J, Taylor RS, Kenny LC, Dekker GA, Walker JJ, McCowan LM, North RA, Poston L. Exploration and confirmation of factors associated with uncomplicated pregnancy in nulliparous women: prospective cohort study. BMJ. 2013;347(f6398):f6398.","journal-title":"BMJ"}],"container-title":["BMC Pregnancy and Childbirth"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-021-03663-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12884-021-03663-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12884-021-03663-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,22]],"date-time":"2023-10-22T08:16:16Z","timestamp":1697962576000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpregnancychildbirth.biomedcentral.com\/articles\/10.1186\/s12884-021-03663-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,5]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3663"],"URL":"https:\/\/doi.org\/10.1186\/s12884-021-03663-2","relation":{},"ISSN":["1471-2393"],"issn-type":[{"value":"1471-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,5]]},"assertion":[{"value":"1 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study used anonymised BORN Ontario birth registry data which is regulated by Ontario\u2019s Personal Health Information Protection Act, 2004 (PHIPA). As a registry, BORN is afforded the authority to collect, use and disclose personal health information, without consent, for the purpose of facilitating or improving the provision of health care. This special authority requires BORN to develop and adhere to privacy policies that have been reviewed and approved by the Information and Privacy Commissioner of Ontario. Research Ethics Board (REB) approvals were obtained from the Children\u2019s Hospital of Eastern Ontario Research Ethics Board (18\/23PE) and the Ottawa Health Science Network Research Ethics Board (20180855-01H).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"182"}}