Spontaneous and indicated preterm delivery risk is increased among overweight and obese women without prepregnancy chronic disease.

<bold>Objective: </bold>To investigate the independent impact of prepregnancy obesity on preterm delivery among women without chronic diseases by gestational age, preterm category and parity.<bold>Design: </bold>A retrospective cohort study.<bold>Setting: </bold>Data from the Consortium on Safe Labor (CSL) in the USA (2002-08).<bold>Population: </bold>Singleton deliveries at ≥23 weeks of gestation in the CSL (43 200 nulliparas and 63 129 multiparas) with a prepregnancy body mass index (BMI) ≥18.5 kg/m2 and without chronic diseases.<bold>Methods: </bold>Association of prepregnancy BMI and the risk of preterm delivery was examined using Poisson regression with normal weight as reference.<bold>Main Outcome Measures: </bold>Preterm deliveries were categorised by gestational age (extremely, very, moderate to late) and category (spontaneous, indicated, no recorded indication).<bold>Results: </bold>Relative risk of spontaneous preterm delivery was increased for extremely preterm among obese nulliparas (1.26, 95% CI: 0.94-1.70 for overweight; 1.88, 95% CI: 1.30-2.71 for obese class I; 1.99, 95% CI: 1.32-3.01 for obese class II/III) and decreased for moderate to late preterm delivery among overweight and obese multiparas (0.90, 95% CI: 0.83-0.97 for overweight; 0.87, 95% CI: 0.78-0.97 for obese class I; 0.79, 95% CI: 0.69-0.90 for obese class II/III). Indicated preterm delivery risk was increased with prepregnancy BMI in a dose-response manner for extremely preterm and moderate to late preterm among nulliparas, as it was for moderate to late preterm delivery among multiparas.<bold>Conclusions: </bold>Prepregnancy BMI was associated with increased risk of preterm delivery even in the absence of chronic diseases, but the association was heterogeneous by preterm categories, gestational age and parity.<bold>Tweetable Abstract: </bold>Obese nulliparas without chronic disease had higher risk for spontaneous delivery <28 weeks of gestation. [ABSTRACT FROM AUTHOR]