Body mass index (BMI) is widely used to assess obesity in pregnancy, yet it may not fully capture cardiometabolic risk. A study published in Diabetes Care evaluated whether measures of central obesity in early pregnancy were associated with perinatal and postpartum cardiometabolic outcomes, independent of BMI.

The analysis included 3,055 individuals and assessed central obesity using waist circumference, waist-to-hip ratio, waist-to-height ratio, and body roundness index. Associations with gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy, postpartum prediabetes or diabetes, and postpartum chronic hypertension were examined using modified Poisson regression for prenatal outcomes and Cox regression for postpartum outcomes.

A graded relationship was observed between increasing central adiposity and all evaluated outcomes, even after adjustment for BMI. Among individuals with a healthy prepregnancy BMI, central obesity was associated with a higher risk of GDM (relative risks 1.92-2.42), postpartum prediabetes or diabetes (hazard ratios [HRs] 1.50-2.16), and postpartum chronic hypertension (HRs 2.04-3.63).

These findings suggest that central obesity measures in early pregnancy may improve identification of individuals at elevated cardiometabolic risk beyond BMI alone.