Preconception weight change and pregnancy, birth, and child outcomes: Design and baseline characteristics of the MatTrack Cohort
- 1University of California San Francisco
Abstract
Current recommendations suggest that women achieve a healthy weight before becoming pregnant, but evidence supporting the benefits of preconception weight loss are limited and inconsistent, with some evidence of risks. The Maternal Preconception Weight Trajectory (MatTrack) study will evaluate the impact of preconception weight change on maternal, pregnancy, and child outcomes. In this paper, we present methods used to construct the cohort and evaluate baseline characteristics.
The MatTrack cohort was derived from electronic health record data from four Kaiser Permanente regions. Inclusion criteria addressed data quality, availability, and enrollment; maternal age ([≥]18 years); and date (pregnancy onset date in 2006-2020, delivery [≤]12/31/2020). Starting body mass index (BMI) was calculated using weight closest to 24 months prior to pregnancy onset date and adult height. Preconception weight change rates from 24 months prior to and through pregnancy onset date were estimated using linear mixed effects models. Descriptive analyses characterized the baseline characteristics of the cohort.
The cohort includes 297,592 pregnancies with the full spectrum of starting BMI: underweight (2.3%), normal weight (41.8%), overweight (28.4%); and obesity class I (15.3%), II (7.4%), and III (5.0%). The cohort is demographically diverse, with 8.3% covered by Medicaid; and 44.5%, 9.2%, and 10.9% Hispanic, non-Hispanic Black, or non-Hispanic Asian, respectively.
Preconception weight change rates (kg/year) span weight loss to gain, with the greatest loss in those with obesity class III [median (10th, 90th percentile): -0.8 (-9.5, 4.9)] and the greatest gain in those with underweight [median (10th, 90th percentile): 1.1 (-0.7, 3.6)].
Longitudinal data from this cohort of nearly 300,000 linked maternal-child dyads will enable examination of associations between preconception weight loss and pregnancy, maternal, and child health outcomes. Findings will strengthen the evidence base for preconception weight management guidelines.
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BibTeX
@misc{mayhew2026preconception,
title = {{Preconception weight change and pregnancy, birth, and child outcomes: Design and baseline characteristics of the MatTrack Cohort}},
author = {M. Mayhew and K. K. Vesco and D. Rohm Young and C. Oshiro and L. S. Clarke and N. Smith and E. S. LeBlanc and A. A. Owen-Smith and C. E. McCraken and M. C. Leo and M. H. Lee and B. Zhou and C. Wong and A. Hudgins and N. A. Rosenquist and J. Boone-Heinonen},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.25.26361309},
url = {https://www.medrxiv.org/content/10.64898/2026.08.25.26361309v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Preconception weight change and pregnancy, birth, and child outcomes: Design and baseline characteristics of the MatTrack Cohort
AU - M. Mayhew
AU - K. K. Vesco
AU - D. Rohm Young
AU - C. Oshiro
AU - L. S. Clarke
AU - N. Smith
AU - E. S. LeBlanc
AU - A. A. Owen-Smith
AU - C. E. McCraken
AU - M. C. Leo
AU - M. H. Lee
AU - B. Zhou
AU - C. Wong
AU - A. Hudgins
AU - N. A. Rosenquist
AU - J. Boone-Heinonen
PY - 2026
DA - 2026/08/25
PB - medRxiv
DO - 10.64898/2026.08.25.26361309
UR - https://www.medrxiv.org/content/10.64898/2026.08.25.26361309v1
AB - Current recommendations suggest that women achieve a healthy weight before becoming pregnant, but evidence supporting the benefits of preconception weight loss are limited and inconsistent, with some evidence of risks. The Maternal Preconception Weight Trajectory (MatTrack) study will evaluate the impact of preconception weight change on maternal, pregnancy, and child outcomes. In this paper, we present methods used to construct the cohort and evaluate baseline characteristics. The MatTrack cohort was derived from electronic health record data from four Kaiser Permanente regions. Inclusion criteria addressed data quality, availability, and enrollment; maternal age ([≥]18 years); and date (pregnancy onset date in 2006-2020, delivery [≤]12/31/2020). Starting body mass index (BMI) was calculated using weight closest to 24 months prior to pregnancy onset date and adult height. Preconception weight change rates from 24 months prior to and through pregnancy onset date were estimated using linear mixed effects models. Descriptive analyses characterized the baseline characteristics of the cohort. The cohort includes 297,592 pregnancies with the full spectrum of starting BMI: underweight (2.3%), normal weight (41.8%), overweight (28.4%); and obesity class I (15.3%), II (7.4%), and III (5.0%). The cohort is demographically diverse, with 8.3% covered by Medicaid; and 44.5%, 9.2%, and 10.9% Hispanic, non-Hispanic Black, or non-Hispanic Asian, respectively. Preconception weight change rates (kg/year) span weight loss to gain, with the greatest loss in those with obesity class III [median (10th, 90th percentile): -0.8 (-9.5, 4.9)] and the greatest gain in those with underweight [median (10th, 90th percentile): 1.1 (-0.7, 3.6)]. Longitudinal data from this cohort of nearly 300,000 linked maternal-child dyads will enable examination of associations between preconception weight loss and pregnancy, maternal, and child health outcomes. Findings will strengthen the evidence base for preconception weight management guidelines.
ER -