{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:20Z","timestamp":1787028620728,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The aim of our study was to investigate whether prepregnancy underweight body mass index (BMI) is associated with preterm birth (PTB) and small-for-gestational age (SGA). This retrospective case-control study included 814 women with live singleton fetuses in vertex presentation that gave birth between January 2016 and November 2016 in two tertiary care hospitals. The study group (n = 407) comprised all women whose prepregnancy BMI was underweight (&lt;18.5 kg\/m2) and who delivered during the study period. A control group (n = 407) was established with women whose prepregnancy BMI was normal (18.5\u201324.9 kg\/m2) by matching age and parity. Univariate and multivariate analyses were performed to compare PTB and SGA associated with prepregnancy underweight BMI. Compared with the control group, the study group had higher rates of overall PTB (10.1% vs. 5.7%, p = 0.02), iatrogenic PTB (4.2% vs. 1.5%, p = 0.02), and SGA (22.1% vs. 11.1%, p &lt; 0.001). In a multivariable analysis, prepregnancy underweight BMI was associated with PTB (aOR 2.32, 95% CI 1.12\u20134.81) and with SGA (aOR 2.38, 95% CI 1.58\u20133.58). In singleton pregnancies, women\u2019s prepregnancy underweight compared with normal BMI was associated with an increase in PTB and in SGA neonates. Identifying this specific high-risk group is pragmatic and practical for all physicians, and they should be aware about perinatal outcome among underweight women.<\/jats:p>","DOI":"10.3390\/jcm10245733","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T11:00:23Z","timestamp":1638874823000},"page":"5733","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Preterm Birth and Small-for-Gestational Age Neonates among Prepregnancy Underweight Women: A Case-Controlled Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Emelyne","family":"Lefizelier","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Centre Hospitalier Departemental, 85000 La Roche sur Yon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Misbert","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Nantes University Hospital, 44000 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Centre Hospitalier Departemental, 85000 La Roche sur Yon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Le Thuaut","sequence":"additional","affiliation":[{"name":"Plateforme de M\u00e9thodologie et Biostatistique, CHU Nantes, 44093 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Winer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Nantes University Hospital, 44000 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-353X","authenticated-orcid":false,"given":"Guillaume","family":"Ducarme","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Centre Hospitalier Departemental, 85000 La Roche sur Yon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2019, November 08). International Classification of Adult Underweight, Overweight and Obesity According to BMI. Available online: http:\/\/www.assesmentpsychology.com\/icbmi.htm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.arcped.2018.03.006","article-title":"Changes in conditions at birth in France from 1995 to 2016: Results of the National Perinatal Surveys","volume":"25","author":"Blondel","year":"2018","journal-title":"Arch. P\u00e9diatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1111\/1471-0528.14027","article-title":"Women\u2019s prepregnancy underweight as a risk factor for preterm birth: A retrospective study","volume":"123","author":"Girsen","year":"2016","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1111\/ppe.12125","article-title":"Maternal Prepregnancy Body Mass Index and Risk of Spontaneous Preterm Birth","volume":"28","author":"Shaw","year":"2014","journal-title":"Paediatr. P\u00e9rinat. Epidemiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"428.e1","DOI":"10.1016\/j.ajog.2013.12.011","article-title":"Association of extremes of prepregnancy BMI with the clinical presentations of preterm birth","volume":"210","author":"Lynch","year":"2014","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1093\/ije\/dyq195","article-title":"Maternal underweight and the risk of preterm birth and low birth weight: A systematic review and meta-analyses","volume":"40","author":"Han","year":"2010","journal-title":"Int. J. Epidemiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"ESH\/ESC (2013). Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH\/ESC Task Force for the Management of Arterial Hypertension. J. Hypertens., 31, 1925\u20131938.","DOI":"10.1097\/HJH.0b013e328364ca4c"},{"key":"ref_8","unstructured":"Rasmussen, K.M., and Yaktine, A.L. (2009). Weight Gain During Pregnancy: Reexamining the Guidelines."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.bpobgyn.2011.10.010","article-title":"Anaemia in pregnancy","volume":"26","author":"Goonewardene","year":"2012","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"International Association of Diabetes Pregnancy Study Groups (2010). Recommendations on the diagnosis and classification of hyperglycaemia in pregnancy. Diabetes Care, 33, 676\u2013682.","DOI":"10.2337\/dc09-1848"},{"key":"ref_11","unstructured":"Coll\u00e8ge national des gyn\u00e9cologues et obst\u00e9triciens fran\u00e7ais, and Soci\u00e9t\u00e9 francophone du diab\u00e8te (2010). Gestational diabetes. J. Gynecol. Obstet. Biol. Reprod., 39, S338\u2013S342."},{"key":"ref_12","unstructured":"American College of Obstetricians and Gynecologists, and Task Force on Hypertension in Pregnancy (2013). Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists\u2019 Task Force on Hypertension in Pregnancy. Obstet. Gynecol., 122, 1122\u20131131."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1016\/j.jgyn.2013.09.012","article-title":"Definitions: Small for gestational age and intrauterine growth retardation","volume":"42","author":"Ego","year":"2013","journal-title":"J. Gynecol. Obstet. Biol. Reprod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ejogrb.2015.06.021","article-title":"Fetal growth restriction and intra-uterine growth restriction: Guidelines for clinical practice from the French College of Gynaecologists and Obstetricians","volume":"193","author":"Sentilhes","year":"2015","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ejogrb.2013.01.026","article-title":"Prolonged and post-term pregnancies: Guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF)","volume":"169","author":"Vayssiere","year":"2013","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jogoh.2018.12.002","article-title":"Perineal prevention and protection in obstetrics: CNGOF clinical practice guidelines","volume":"48","author":"Ducarme","year":"2019","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.ejogrb.2015.12.012","article-title":"Postpartum hemorrhage: Guidelines for clinical practice from the French Society of Anesthesiology and Intensive Care (SFAR)","volume":"198","author":"Sentilhes","year":"2016","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jgyn.2006.09.001","article-title":"Birth weight and size: Charts and equations","volume":"36","author":"Salomon","year":"2007","journal-title":"J. Gynecol. Obstet. Biol. Reprod."},{"key":"ref_19","first-page":"61","article-title":"Fetal growth from the AUDIPOG study. I. Establishment of reference curves","volume":"25","author":"Mamelle","year":"1996","journal-title":"J. Gynecol. Obstet. Biol. Reprod."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.arcped.2004.09.023","article-title":"Neonatal resuscitation in delivery room: New advances","volume":"12","author":"Chabernaud","year":"2005","journal-title":"Arch. Pediatr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.siny.2016.08.007","article-title":"Nonatal hypoglycemia","volume":"22","author":"Adamkin","year":"2017","journal-title":"Seminars Semin Fetal Neonatal Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/S0140-6736(01)06341-3","article-title":"Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: A cohort study","volume":"358","author":"Murphy","year":"2001","journal-title":"Lancet"},{"key":"ref_23","first-page":"61","article-title":"Is maternal underweight really a risk factor for adverse pregnancy outcome? A population-based study in London","volume":"108","author":"Sebire","year":"2001","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.ejogrb.2009.02.047","article-title":"Low pre-pregnancy body mass index and risk of medically indicated versus spontaneous preterm singleton birth","volume":"144","author":"Salihu","year":"2009","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1111\/obr.12293","article-title":"Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: A systematic review and meta-analysis","volume":"16","author":"Rahman","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1002\/eat.23251","article-title":"Pregnancy outcomes in women with anorexia nervosa","volume":"53","author":"Ante","year":"2020","journal-title":"Int. J. Eat. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"105243","DOI":"10.1016\/j.earlhumdev.2020.105243","article-title":"Depression during pregnancy and the risk of low birth weight, preterm birth and intrauterine growth restriction- an updated meta-analysis","volume":"152","author":"Ghimire","year":"2021","journal-title":"Early Hum. Dev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/ppe.12534","article-title":"Economic conditions during pregnancy and preterm birth: A maternal fixed-effects analysis","volume":"33","author":"Margerison","year":"2019","journal-title":"Paediatr. P\u00e9rinat. Epidemiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/ppe.12687","article-title":"Population-based study of serum ferritin in early pregnancy and adverse perinatal outcomes","volume":"34","author":"Ray","year":"2020","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.ejogrb.2020.12.040","article-title":"Impact of maternal underweight on obstetric and neonatal prognosis: A retrospective study","volume":"260","author":"Salmon","year":"2021","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1111\/j.1471-0528.1999.tb08142.x","article-title":"A complete list of members of the Europop Group may be found on page 1169 Very and moderate preterm births: Are the risk factors different?","volume":"106","author":"Ancel","year":"1999","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.ijgo.2006.06.021","article-title":"Pre-pregnancy body mass index and pregnancy outcomes","volume":"95","author":"Doherty","year":"2006","journal-title":"Int. J. Gynecol. Obstet."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/24\/5733\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:42:46Z","timestamp":1760168566000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/24\/5733"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,7]]},"references-count":32,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["jcm10245733"],"URL":"https:\/\/doi.org\/10.3390\/jcm10245733","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,7]]}}}