Is obesity still increasing among pregnant women? Prepregnancy obesity trends in 20 states, 2003-2009

Abstract

Objective: To estimate trends in prepregnancy obesity prevalence among women who delivered live births in the US during 2003-2009, by state, age, and race-ethnicity.

Methods: We used Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2003, 2006, and 2009 to measure prepregnancy obesity (body mass index [BMI]≥30kg/m(2)) trends in 20 states. Trend analysis included 90,774 records from 20 US states with data for all 3 study years. We used a chi-square test for trend to determine the significance of actual and standardized trends, standardized to the age and race-ethnicity distribution of the 2003 sample.

Results: Prepregnancy obesity prevalence increased by an average of 0.5 percentage points per year, from 17.6% in 2003 to 20.5% in 2009 (P<0.001). Obesity increased among women aged 20-24 (P<0.001), 30-34 (P=0.001) and 35 years or older (P=0.003), and among non-Hispanic white (P<.001), non-Hispanic black (P=0.02), Hispanic (P=0.01), and other women (P=0.03).

Conclusion: Overall, prepregnancy obesity prevalence continues to increase and varies by race-ethnicity and maternal age. These findings highlight the need to address obesity as a key component of preconception care, particularly among high-risk groups.

Fig. 1

Prepregnancy obesity (BMI ≥ 30 kg/m²) prevalence among 20 US States, 2003, 2006, and 2009. P-trend < 0.001. Prevalence estimate is standardized to the sample’s 2003 race–ethnicity and age distribution. Standard errors are: 2003–0.4, 2006–0.4, 2009–0.4.

Fig. 2

Prepregnancy obesity prevalence by US state, 2003, 2006, and 2009 (obesity ≥ 30 kg/m²).