Talk:Abnormal Development - Maternal Obesity
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Cite this page: Hill, M.A. (2024, June 9) Embryology Abnormal Development - Maternal Obesity. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Abnormal_Development_-_Maternal_Obesity |
2014
Maternal overweight and obesity in early pregnancy and risk of infant mortality: a population based cohort study in Sweden
Stefan Johansson, Eduardo Villamor, Maria Altman, Anna-Karin Edstedt Bonamy, Fredrik Granath, Sven Cnattingius
Abstract
Objective To investigate associations between maternal overweight and obesity and infant mortality outcomes, including cause-specific mortality.
Design Population based cohort study.
Setting and participants 1 857 822 live single births in Sweden 1992–2010.
Main outcome measures Associations between maternal body mass index (BMI) in early pregnancy and risks of infant, neonatal, and postneonatal mortality, overall and stratified by gestational length and by causes of infant death. Odds ratios were adjusted for maternal age, parity, smoking, education, height, country of birth, and year of delivery.
Results Infant mortality rates increased from 2.4/1000 among normal weight women (BMI 18.5–24.9) to 5.8/1000 among women with obesity grade 3 (BMI ≥40.0). Compared with normal weight, overweight (BMI 25.0–29.9) and obesity grade 1 (BMI 30.0–34.9) were associated with modestly increased risks of infant mortality (adjusted odds ratios 1.25 (95% confidence interval 1.16 to 1.35) and 1.37 (1.22 to 1.53), respectively), and obesity grade 2 (BMI 35.0–39.9) and grade 3 were associated with more than doubled risks (adjusted odds ratios 2.11 (1.79 to 2.49) and 2.44 (1.88 to 3.17)). In analyses stratified by preterm and term births, maternal BMI was related to risks of infant mortality primarily in term births (≥37 weeks), where risks of deaths due to birth asphyxia and other neonatal morbidities increased with maternal overweight and obesity. Obesity grade 2–3 was also associated with increased infant mortality due to congenital anomalies and sudden infant death syndrome.
Conclusions Maternal overweight and obesity are associated with increased risks of infant mortality due to increased mortality risk in term births and an increased prevalence of preterm births. Maternal overweight and obesity may be an important preventable risk factor for infant mortality in many countries.
BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g6572 (Published 02 December 2014) Cite this as: BMJ 2014;349:g6572
PLoS Med. 2014 May 20;11(5):e1001648. doi: 10.1371/journal.pmed.1001648. eCollection 2014.
Persson M1, Johansson S1, Villamor E2, Cnattingius S1.
Abstract
BACKGROUND: Maternal overweight and obesity increase risks of pregnancy and delivery complications and neonatal mortality, but the mechanisms are unclear. The objective of the study was to investigate associations between maternal body mass index (BMI) in early pregnancy and severe asphyxia-related outcomes in infants delivered at term (≥37 weeks). METHODS AND FINDINGS: A nation-wide Swedish cohort study based on data from the Medical Birth Register included all live singleton term births in Sweden between 1992 and 2010. Logistic regression analyses were used to obtain odds ratios (ORs) with 95% CIs for Apgar scores between 0 and 3 at 5 and 10 minutes, meconium aspiration syndrome, and neonatal seizures, adjusted for maternal height, maternal age, parity, mother's smoking habits, education, country of birth, and year of infant birth. Among 1,764,403 term births, 86% had data on early pregnancy BMI and Apgar scores. There were 1,380 infants who had Apgar score 0-3 at 5 minutes (absolute risk = 0.8 per 1,000) and 894 had Apgar score 0-3 at 10 minutes (absolute risk = 0.5 per 1,000). Compared with infants of mothers with normal BMI (18.5-24.9), the adjusted ORs (95% CI) for Apgar scores 0-3 at 10 minutes were as follows: BMI 25-29.9: 1.32 (1.10-1.58); BMI 30-34.9: 1.57 (1.20-2.07); BMI 35-39.9: 1.80 (1.15-2.82); and BMI ≥40: 3.41 (1.91-6.09). The ORs for Apgar scores 0-3 at 5 minutes, meconium aspiration, and neonatal seizures increased similarly with maternal BMI. A study limitation was lack of data on effects of obstetric interventions and neonatal resuscitation efforts. CONCLUSION: Risks of severe asphyxia-related outcomes in term infants increase with maternal overweight and obesity. Given the high prevalence of the exposure and the severity of the outcomes studied, the results are of potential public health relevance and should be confirmed in other populations. Prevention of overweight and obesity in women of reproductive age is important to improve perinatal health. PMID 24845218
