TITLE:
Association between Prepregnancy Obesity and Adverse Birth Outcomes among Mississippi Women
AUTHORS:
Ebele Okoye, Vincent L. Mendy, Mary Shaw, Jung Hye Sung, Azad Bhuiyan, Marinelle Payton
KEYWORDS:
Adverse Pregnancy Outcomes, Cesarean Delivery, Maternal Health, Prepregnancy Obesity, Preterm Birth, PRAMS, Mississippi
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.10,
October
29,
2026
ABSTRACT: Background: Prepregnancy obesity is associated with increased risk of adverse maternal and neonatal outcomes, including preterm birth and cesarean delivery. However, limited evidence exists from Mississippi-specific populations despite the state’s high burden of obesity and adverse birth outcomes. Objective: This study examined the association between prepregnancy obesity and adverse birth outcomes, including cesarean delivery and preterm birth, among Mississippi women. Methods: We conducted a cross-sectional study using data from the Mississippi Pregnancy Risk Assessment Monitoring System, 2016-2022. The exposure was prepregnancy obesity (BMI ≥30.0 kg/m2), and the outcomes were cesarean delivery and preterm birth. Multivariable logistic regression analyses estimated the crude ratios (ORs) and adjusted odds ratios (AORs) with 95% confidence intervals (CIs), adjusting for covariates. Results: This study showed that among Mississippi women with live births (7,016), 51.6% were primarily White, and 53.4% were unmarried. About 57.3% had higher school education, 42.0% earned ≤$20,000 annually, and 77.5% had insurance before pregnancy. There was a statistically significant association between prepregnancy obesity and cesarean delivery in all the models. Mississippi women with prepregnancy obesity had higher odds of cesarean delivery (AOR = 2.09; 95% CI: 1.86 - 2.42) compared to women without obesity, after adjusting for covariates. Although prepregnancy obesity was associated with preterm birth in the unadjusted analyses (OR = 1.29; 95% CI: 1.11 - 1.51), but the association was not statistically significant after adjusting for covariates (AOR = 1.10; 95% CI: 0.93 - 1.31). Conclusion: Prepregnancy obesity is an independent predictor of cesarean delivery among women in Mississippi. These findings may inform public health practitioners and policymakers in developing interventions that promote preconception weight screening and obesity prevention.