NCHS Data Brief ■ No. 392 ■ November 2020

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Increases in Prepregnancy Obesity: United States, 2016–2019 

Anne K. Driscoll, Ph.D., and Elizabeth C.W. Gregory, M.P.H.

Key findings

Data from the National 

Vital Statistics System

● Prepregnancy obesity in

the United States rose from

26.1% in 2016 to 29.0% in

2019 and increased steadily

for non-Hispanic white,

non-Hispanic black, and

Hispanic women.

● From 2016 through 2019,

prepregnancy obesity increased

among women of all ages and

was lowest for women under

age 20 (20.5% in 2019).

● From 2016 through 2019,

women with less than a

bachelor’s degree were more

likely to have prepregnancy

obesity than those with a

bachelor’s degree or higher,

but obesity increased over time

among all education levels.

● Compared with 2016,

prepregnancy obesity 

rose in every state but 

Vermont in 2019.

Obesity (body mass index [BMI] of 30.0 and over) has risen in the 

United States in recent decades (1). Obesity varies by demographic factors, 

such as age, race and Hispanic origin, and socioeconomic status (2,3). 

Maternal obesity has been linked to a variety of adverse health outcomes 

for mothers and newborns, including gestational diabetes, hypertension, 

preeclampsia, cesarean delivery, preterm delivery, large size for gestational 

age, and infant death (4–10). The 2016 natality data file is the first for which 

prepregnancy BMI is available for all states and the District of Columbia 

(D.C.). This report presents trends in prepregnancy obesity for 2016 through 

2019 by maternal race and Hispanic origin, age, and educational attainment. 

Trends by state for 2016–2019 and 2019 rates also are shown.

Prepregnancy obesity in the United States rose overall and 

for the three largest race and Hispanic-origin groups from 

2016 through 2019. 

0

20

25

30

35

40

Hispanic1

Non-Hispanic black1

Non-Hispanic white1

Total1

20192 20182 20172 20162

Figure 1. Prepregnancy obesity, by maternal race and Hispanic origin: United States, 2016–2019

1Significant increasing trend from 2016 through 2019 (p < 0.05). 2Significant difference between all race and Hispanic-origin groups (p < 0.05).

NOTES: Obesity is a body mass index of 30.0 or higher. Total includes all race and Hispanic-origin groups. Access data table for 

Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db392-tables-508.pdf#1.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality file. Percent

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
NCHS Data Brief ■ No. 392 ■ November 2020

■  2  ■

● The percentage of women with prepregnancy obesity rose from 26.1% in 2016 to 29.0% in 

2019, an 11% increase (Figure 1).

● The percentage of non-Hispanic white women with obesity rose 10% (from 24.1% to 

26.6%), 7% for non-Hispanic black women (36.4% to 39.1%), and 12% for Hispanic 

women (28.9% to 32.4%).

● During each year from 2016 through 2019, the percentage of women with prepregnancy 

obesity was highest for non-Hispanic black women and lowest for non-Hispanic 

white women. 

Prepregnancy obesity rose from 2016 through 2019 for all age groups.

● The percentage of women with prepregnancy obesity rose 13% for women under age 20 

(from 18.1% in 2016 to 20.5% in 2019), 12% for women aged 20–29 (27.2% to 30.4%), 

10% for women aged 30–39 (25.8% to 28.3%), and 9% for women aged 40 and over (28.0% 

to 30.4%) (Figure 2). 

● Women under age 20 were the least likely to have prepregnancy obesity compared with 

women of all other ages for each year from 2016 through 2019. 

Figure 2. Prepregnancy obesity, by maternal age: United States, 2016–2019

1Significant increasing trend from 2016 through 2019 (p < 0.05). 2Significant difference between all age groups (p < 0.05).

NOTES: Obesity is a body mass index of 30.0 or higher. Total includes all race and Hispanic-origin groups. Access data table for Figure 2 at: 

https://www.cdc.gov/nchs/data/databriefs/db392-tables-508.pdf#2.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality file. Percent

0

15

20

25

30

35

40 and over1

30–391

20–291

Under 201

2018 2019 2 20172 20162
NCHS Data Brief ■ No. 392 ■ November 2020

■  3  ■

Prepregnancy obesity rose among women of all education levels from 2016 

through 2019. 

● Among women aged 25 and over, prepregnancy obesity increased by 10% for women with 

a high school education or less (from 33.2% to 36.5%) and for women with some college 

education (from 34.2% to 37.5%) (Figure 3).

● Prepregnancy obesity rose by 11% for women with an associate’s degree (from 30.7% to 

34.1%), 13% for women with a bachelor’s degree (19.0% to 21.5%), and 13% among those 

with a master’s degree or higher (15.3% to 17.3%).

● During each year from 2016 through 2019, women with less than a bachelor’s degree were 

more likely to have prepregnancy obesity than those with a bachelor’s degree or higher. 

Figure 3. Prepregnancy obesity, by maternal education: United States, 2016–2019

1Significant increasing trend from 2016 through 2019 (p < 0.05). 2Significant difference between all education groups (p < 0.05).

NOTES: Obesity is a body mass index of 30.0 or higher. Total includes all race and Hispanic-origin groups. Access data table for Figure 3 at: 

https://www.cdc.gov/nchs/data/databriefs/db392-tables-508.pdf#3.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality file. Percent

0

15

20

25

30

35

40

Master's degree or higher1

Bachelor's degree1

Associate's degree1

Some college1

High school or less1

20192 20182 20172 20162
NCHS Data Brief ■ No. 392 ■ November 2020

■  4  ■

Prepregnancy obesity rose in almost every state in 2019 compared with 

2016. 

● During 2019, prepregnancy obesity increased in 49 states and D.C. compared with 2016; no 

significant increase was seen in Vermont (Figure 4).

● Prepregnancy obesity increased by less than 10.0% in 22 states, between 10.0% and 13.9% 

in 26 states and D.C., and by 22.0% in Arkansas.

● During 2019, prepregnancy obesity ranged from a low of 22.6% in D.C. to a high of 37.6% 

in Mississippi.

Figure 4. Prepregnancy obesity, 2019 and percent change, 2016–2019: United States and each state 

NOTES: Obesity is a body mass index of 30.0 or higher. Increases from 2016 through 2019 are significant (p < 0.05). Access data table for Figure 4 at: 

https://www.cdc.gov/nchs/data/databriefs/db392-tables-508.pdf#4.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality file.

OR

28.0

CA

26.6

AZ

29.9

AK

28.8

HI

26.4

NM

30.7

TX

29.8

LA

34.0

MS

37.6

AL

35.1

GA

31.4

OH

30.9

FL

27.1

AR

35.5

MO

30.6

TN

30.1

KY

33.2

NE

27.9

OK

33.0

KS

30.3

NV

27.2 UT

23.8 CO

23.8

WA

26.4

ID

27.4

MT

26.9 ND

33.1

WY

25.0

SD

28.0

WI

32.6 MI

31.8

ME

31.4

NH

VT 27.5

28.6

NY

24.5

PA

28.2

WV

35.0 VA

28.9

NC

30.4

SC

34.4

IN

33.3

IL

30.7

MN

29.1

IA

31.2

MA

23.4

RI

27.0

NJ

24.0

DE

MD 33.2

28.2

CT

25.9

DC

22.6

Less than 10.0

10.0–13.9

14.0 and over

No significant 

change

U.S. 2016 average is 26.1

U.S. 2019 average is 29.0

U.S. percent change from 

2016 through 2019 is 11.1
NCHS Data Brief ■ No. 392 ■ November 2020

■  5  ■

Summary

During 2019, almost 3 in 10 (29.0%) women had obesity prior to becoming pregnant, an 11% 

increase from 2016 that continued the pattern seen prior to 2016 (11,12). Increases occurred 

across all maternal ages, race and Hispanic-origin groups, and educational levels shown in this 

report. Women under age 20 and those with a bachelor’s degree or higher were the least likely 

to have obesity; however, these groups had greater percentage increases in prepregnancy obesity 

from 2016 through 2019 than women aged 20 and over and women with less education. 

Prepregnancy obesity increased in all states but Vermont in 2019 compared with 2016; increases 

ranged from 4% to 22%. The lowest level in 2019 was seen in D.C.; the highest in Mississippi. 

Definitions 

Body mass index (BMI): Measure of body fat based on height and weight and calculated as 

kg/m2

 (703 ∙ lbs/in2). BMI values under 18.5 were classified as underweight; those from 18.5 

to 24.9 were classified as normal or healthy weight; values from 25.0 to 29.9 were classified as 

overweight; and values of 30.0 and over were classified as obese. 

Educational attainment: The highest degree or level of school completed by the mother at the time 

of birth. The education categories are 8th grade or less; 9th through 12th grade, with no diploma; 

high school graduate or GED completed; some college, but no degree; associate’s degree; 

bachelor’s degree; master’s degree; and doctorate or other professional degree. 

Prepregnancy weight and height: Mother’s weight immediately before pregnancy was reported 

by the mother via the question, “What was your prepregnancy weight, that is, your weight 

immediately before you became pregnant with this child?” Mother’s height also was reported by 

the mother via the question, “What is your height?”
NCHS Data Brief ■ No. 392 ■ November 2020

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Data source and methods

This report is based on data from the Natality Data Files from the National Vital Statistics 

System. The vital statistics’ natality file is created from birth certificates and includes information 

for all births occurring in the United States. The natality files include information on a wide 

range of maternal and infant demographic and health characteristics for babies born in the 

United States. 

Race and Hispanic origin are reported separately on the birth certificate. Persons of Hispanic 

origin may be of any race. Persons of non-Hispanic ancestry are further classified by race. Race 

categories are based on the 1997 Office of Management and Budget standards. Single race is 

defined as only one race reported on the birth certificate. 

References to differences in prepregnancy obesity percentages between groups mean that the 

difference is statistically significant at the 0.05 level based on a two-tailed z test. References 

to increasing trends are statistically significant at the 0.05 level and were assessed using the 

Cochran–Armitage test for trends, a modified chi-squared test.

Analyses of educational attainment were limited to women aged 25 and over.

About the authors

Anne K. Driscoll and Elizabeth C.W. Gregory are with the National Center for Health Statistics, 

Division of Vital Statistics, Reproductive Statistics Branch. 
NCHS Data Brief ■ No. 392 ■ November 2020

■  7  ■

References

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NCHS Data Brief ■ No. 392 ■ November 2020

Suggested citation

Driscoll AK, Gregory ECW. Increases 

in prepregnancy obesity: United States, 

2016–2019. NCHS Data Brief, no 392. 

Hyattsville, MD: National Center for Health 

Statistics. 2020.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Brian C. Moyer, Ph.D., Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Vital Statistics

Steven Schwartz, Ph.D., Director

Isabelle Horon, Dr.P.H., Acting Associate 

Director for Science

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Keywords: National Vital Statistics System • body mass index • maternal 

factors • trends