Article Figures & Data
Tables
Classification BMI Underweight <18.5 Normal Weight 18.5–24.9 Overweight 25.0–29.9 Obese Class I 30.0–34.9 Class II 35–39.9 Class III* >40 * Morbid obesity or extreme obesity.
Authors Assessment of Obesity Results Effect* (OR [RR]) Brown et al (20) BMI >30 Increased incidence of LBP 1.26 (1.08–1.48) Shiri et al (21) BMI >35 in women aged 24–39 years Increased incidence of LBP 1.2 (0.8–1.8) Tsuritani et al (22) BMI >24 vs BMI = 20–24 in women >40 years old Increased incidence of LBP and disability 1.46 (0.78–2.47)† 1.29 (0.74–2.25)‡ BMI >26 vs BMI = 20–24 in women >40 years old Increased incidence of LBP and disability 1.22 (0.58–2.57)† 2.44 (1.24–4.81)‡ Guh et al (9) BMI >30 Increased incidence of chronic LBP 2.81 (2.27–3.48) * All odds ratios (OR) and relative risk (RR) are compared to women with body mass index (BMI) <25, unless otherwise noted.
† Back pain.
‡ Disability.
Authors Assessment of Obesity Results Effect* (OR [RR]) Abbate et al (30) BMI: heaviest quartile vs lowest quartile Increased diagnosis of knee OA 5.27 (3.05–9.13) Weight: heaviest quartile vs lowest quartile Increased diagnosis of knee OA 5.28 (3.05–9.16) Grotle et al (31) BMI >30 Increased diagnosis of new knee OA within 10 years 2.81 (1.32–5.96) Holmberg et al (32) BMI increase from 23 to 25 Increased radiograph diagnosis of knee OA 1.6 (0.9–3.1) Liu et al (33) BMI >30 vs BMI <22.5 Increased rates of knee replacement 10.51 (7.85–14.08) Patterson et al (12) BMI >35 Increased rates of knee replacement 11.7 * All odds ratio (OR) and relative risk (RR) are compared to women with body mass index (BMI) <25, unless otherwise noted.
OA, osteoarthritis.
Contraceptive Precautions Triphasic oral contraceptive (eg, Ortho Tri Cyclen, Ortho-McNeil-Janssen Pharmaceuticals, Inc., Raritan, NJ) Increased body weight and surface area are associated with decreased hormone concentration (overweight is not listed as a precaution). Monophasic Oral Contraceptive (eg, Loestrin 24 Fe, Warner Chilcott, Rockaway, NJ) No weight-specific comments. Progesterone-only contraceptive (eg, Ortho Micronor, Ortho-McNeil-Janssen Pharmaceuticals, Inc., Raritan, NJ) No weight-specific comments. Transdermal contraceptive (eg, Ortho Evra, Ortho-McNeil-Janssen Pharmaceuticals, Inc., Raritan, NJ) Consider decreased effectiveness >90 kg (this is listed as a precaution). Intravaginal ring (eg, Nuva ring, Schering-Plough Corp., Kenilworth, NJ) No weight-specific comments. Implantable progesterone (eg, Implanon, Schering-Plough Corp., Kenilworth, NJ) Effectiveness not defined because women with >130% of ideal body weight were not studied. However, the hormonal concentration is inversely related to body weight and thus may be less effective in overweight patients. Injectable progesterone (eg, Depo-provera, Pfizer, Inc., New York, NY) No weight-specific comments. Hormonal intrauterine device (eg, Mirena, Bayer HealthCare Pharmaceuticals, Montville, NJ) No weight-specific comments. Condition Type of Study Effect* GDM (53) Meta-analysis OR, 2.14 (1.82–2.53)† OR, 3.56 (3.05–4.21)‡ OR, 8.56 (5.07–16.04)§ PIH (54) Meta-analysis OR, 2.5 (2.1–3.0)‡ OR, 3.2 (2.6–4.0)§ C-section (55) Population-based cohort study RR, 2.6 (2.04–2.51)‡ RR, 3.38 (2.49–4.57) Pre-eclampsia (53) Meta-analysis OR, 1.6 (1.1–2.25)‡ OR, 3.3 (2.4–4.5)§ Preeclampsia (56) Retrospective cohort study OR, 7.2 (4.7–11.2)§ Induction of labor (56) Retrospective cohort study OR, 1.8 (1.3–2.5)§ Postpartum hemorrhage (56) Population-based cohort study OR, 1.5 (1.3–1.7)‖ Preterm delivery (<33 weeks) (56) Population-based cohort study OR, 2.0 (1.3–2.9)‖ Stillbirth (57) Systematic review and meta-anaylsis OR, 1.47† RR, 2.07‖ Stillbirth (58) Population-based cohort study OR, 2.8 (1.5–5.3)‖ Neonatal death (58) Population-based cohort study OR, 2.6 (1.2–5.8)‖ * All odds ratio (OR) and relative risk (RR) are compared to normal weight pregnant women (body mass index [BMI] 18–25). Values in parentheses indicate 95% CI.
† BMI 25–30.
‡ BMI 30–35.
§ BMI >35.
‖ BMI >30. GDM, gestational diabetes mellitus. PIH, pregnancy-induced hypertension.