Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta‐analysis of European, North American and Australian cohorts

Susana Santos(Erasmus MC), Ellis Voerman(Erasmus MC), Pilar Amiano(Biogipuzkoa Health Research Institute), Henrique Barros(Universidade do Porto), Lawrence J. Beilin(The University of Western Australia), Anna Bergström(Stockholm County Council), Marie‐Aline Charles(Inserm), L. Chatzi(University of Southern California), Cécile Chevrier(Inserm), GP Chrousos(National and Kapodistrian University of Athens), Eva Corpeleijn(University Medical Center Groningen), O. A. Dalla Costa(Universitat Jaume I), Nathalie Costet(Inserm), Sarah Crozier(MRC Lifecourse Epidemiology Unit), Graham Devereux(Liverpool School of Tropical Medicine), Myriam Doyon(Université de Sherbrooke), Merete Eggesbø(Norwegian Institute of Public Health), MP Fantini(University of Bologna), Sara Farchi, Francesco Forastiere, Vagelis Georgiu(University of Crete), Keith M. Godfrey(University Hospital Southampton NHS Foundation Trust), Davide Gori(University of Bologna), Veit Grote(Ludwig-Maximilians-Universität München), Wojciech Hanke(Nofer Institute of Occupational Medicine), Irva Hertz‐Picciotto(University of California, Davis), Barbara Heude(Inserm), M‐F Hivert(Université de Sherbrooke), Daniel Hryhorczuk(Illinois College), R‐C Huang(The Kids Research Institute Australia), Hazel Inskip(University Hospital Southampton NHS Foundation Trust), AM Karvonen(Finnish Institute for Health and Welfare), Louise C. Kenny(University College Cork), Berthold Koletzko(Ludwig-Maximilians-Universität München), Leanne K. Küpers(University Medical Center Groningen), Hanna Lagström(University of Turku), Irina Lehmann(Helmholtz Centre for Environmental Research), Per Magnus(Norwegian Institute of Public Health), Renata Majewska(Jagiellonian University), Johanna Mäkelä(Åbo Akademi University), Yannis Μanios(Harokopio University of Athens), Fionnuala M. McAuliffe(University College Dublin), S W McDonald(University of Calgary), John Mehegan(University College Dublin), E. Melén(Karolinska Institutet), Monique Mommers(Maastricht University), CS Morgen(University of Copenhagen), George Moschonis(La Trobe University), David M. Murray(University College Cork), Carol Ní Chaoimh(University College Cork), Ellen A. Nøhr(University of Southern Denmark), A‐M Nybo Andersen(University of Copenhagen), Emily Oken(Harvard University), AJJM Oostvogels(Amsterdam UMC Location University of Amsterdam), Agnieszka Pac(Jagiellonian University), Eleni Papadopoulou(Norwegian Institute of Public Health), Juha Pekkanen(University of Helsinki), Costanza Pizzi(University of Turin), Kinga Polańska(Nofer Institute of Occupational Medicine), Daniela Porta, Lorenzo Richiardi(University of Turin), SL Rifas‐Shiman(Harvard University), Nel Roeleveld(Radboud University Nijmegen), Luca Ronfani(IRCCS Materno Infantile Burlo Garofolo), Ana Cristina Santos(Universidade do Porto), Marie Standl(Helmholtz Zentrum München), Hein Stigum(Norwegian Institute of Public Health), Camilla Stoltenberg(Norwegian Institute of Public Health), Elisabeth Thiering(Helmholtz Zentrum München), Carel Thijs(Maastricht University), Maties Torrent(Parc de Salut), Suzanne Tough(University of Calgary), T Trnovec(Slovak Medical University), Steve Turner(Royal Aberdeen Children's Hospital), MMHJ van Gelder(Radboud University Nijmegen), Lenie van Rossem(Utrecht University), Andrea von Berg(Marien Hospital Wesel), Martine Vrijheid(Universitat Pompeu Fabra), TGM Vrijkotte(Amsterdam UMC Location University of Amsterdam), Jane West(Bradford Royal Infirmary), A. H. Wijga(National Institute for Public Health and the Environment), John Wright(Bradford Royal Infirmary), Олександр Звінчук, TIA Sørensen(University of Copenhagen), Debbie A. Lawlor(University of Bristol), Romy Gaillard(Erasmus MC), VWV Jaddoe(Erasmus MC)
BJOG An International Journal of Obstetrics & Gynaecology
February 20, 2019
10.1111/1471-0528.15661
Cited by 584Open Access
Full Text

Abstract

OBJECTIVE: To assess the separate and combined associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact. DESIGN: Individual participant data meta-analysis of 39 cohorts. SETTING: Europe, North America, and Oceania. POPULATION: 265 270 births. METHODS: Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used. MAIN OUTCOME MEASURES: Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth. RESULTS: Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31- 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain. CONCLUSIONS: Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity. TWEETABLE ABSTRACT: Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.

Related Papers

No related papers found

Powered by citation graph analysis