HSR&D Citation Abstract
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Differences in body mass index based on self-reported versus measured data from women veterans.
Breland JY, Joyce VR, Frayne SM, Phibbs C. Differences in body mass index based on self-reported versus measured data from women veterans. Obesity science & practice. 2020 Aug 1; 6(4):434-438.
The objective was to compare differences in body mass index (BMI) calculated with self-reported versus clinically measured pre-conception data from women veterans in California.
Veterans Health Administration (VHA) and California state birth certificate data were used to develop a cohort of women who gave birth from 2007-2012 and had VHA data available to calculate BMI ( = 1,326 mothers, 1,473 births). Weighted Kappa statistics assessed concordance between self-reported and measured BMI. A linear mixed-effects model with maximum likelihood estimation, adjusted for mother as a random effect, assessed correlates of differences in BMI.
Mean BMI was in the overweight range based on self-reported (26.2 kg/m, SD: 5.2) and measured (26.8 kg/m, SD: 5.2) data. Weighted Kappa statistics indicated good agreement between self-reported and measured BMI (0.73, 95% CI: 0.70, 0.76). Compared to the normal weight group, groups with overweight or obesity were significantly more likely to have lower BMIs when calculated using self-reported versus measured heights and weights, in unadjusted and adjusted models. The finding was pronounced for class 3 obesity, which was associated with a BMI underestimation of 6.4 kg/m.
Epidemiologic research that guides the clinical care of pregnant women should account for potential under-estimation of BMI in heavier women, and perform direct measurement where feasible.