Early Pregnancy Central Obesity and Risk of Prenatal and Postpartum Diabetes and Hypertensive Disorders

OBJECTIVE Despite limitations in using BMI to assess obesity, little is known about central obesity’s role in pregnancy and postpartum cardiometabolic conditions. We investigated associations of central obesity with perinatal cardiometabolic conditions, independently and jointly with BMI. RESEARCH DESIGN AND METHODS We examined associations of early pregnancy central obesity measures (waist circumference, waist-to-hip ratio, waist-to-height ratio, and body roundness index) with gestational diabetes mellitus, hypertensive disorders of pregnancy, postpartum prediabetes/diabetes, and postpartum chronic hypertension using modified Poisson (prenatal outcomes) and Cox (postpartum outcomes) regression. RESULTS Among the 3,055 individuals in the study, there was a dose-response relationship between increasing central obesity and all outcomes, even after adjusting for BMI. Among individuals with healthy prepregnancy BMI, central obesity was associated with a higher risk of gestational diabetes mellitus (relative risks 1.92–2.42), postpartum prediabetes/diabetes (hazard ratios HRs 1.50–2.16), and postpartum chronic hypertension (HRs 2.04–3.63). CONCLUSIONS Early pregnancy central obesity measures may enhance perinatal cardiometabolic risk assessment, helping identify at-risk individuals who could be missed using BMI alone.