Association of Maternal Obesity with Child Cerebral Palsy or Death

Abstract

The primary aim of this study was to determine if there is an association between maternal obesity and cerebral palsy or death in children. This is a retrospective cohort analysis of a randomized controlled clinical trial previously performed by the Maternal-Fetal Medicine Units Network. Women in the original trial were included if at high risk for preterm delivery. The present study included singletons enrolled in the original study with complete data. Obese and nonobese women were compared. A secondary analysis comparing class 3 obese or classes 1 to 2 obese women to nonobese women was performed. The primary outcome was a composite of cerebral palsy or perinatal death. In this study, 1,261 nonobese, 339 obese, and 69 morbidly obese women were included. When adjusted for gestational age at delivery and magnesium exposure, there was no association between maternal obesity and child cerebral palsy or death. In the analysis using obesity severity categories, excess risk for adverse outcome appeared confined to the class 3 obese group. In women at high risk of delivering preterm, maternal obesity was not independently associated with child cerebral palsy or death. The association in unadjusted analysis appears to be mediated by preterm birth among obese patients.

Association between maternal overweight or obesity and cerebral palsy in children: A meta-analysis

“…Obesity is becoming an epidemic health problem. This trend is particularly true for maternal obesity and overweight, which may be associated with adverse obstetric complications[ 1 , 2 ]. Maternal obesity is associated with low Apgar scores at 5 minutes[ 2 , 3 ], preterm birth[ 4 ], low birth weight, periventricular leukomalacia (PVL)[ 5 ], autism spectrum disorders (ASDs)[ 6 , 7 ], and intellectual disability[ 8 ], which could alter the offspring’s neurodevelopmental outcomes[ 6 ].…”

“…Maternal obesity and overweight are the leading cause of public health problems. More than half of women receiving prenatal care in the United States are overweight or obese[ 12 ], and maternal obesity and overweight are epidemic in Sweden[ 13 ] and other countries.…”

“…Studies show that maternal chorioamnionitis[ 15 ], maternal preeclampsia[ 16 ], maternal age >35 years, a low Apgar score at 5 minutes, preterm birth[ 17 ], low birth weight, periventricular/intraventricular hemorrhage[ 18 ], and bronchopulmonary dysplasia (BPD) are associated with CP. Among recent studies focusing on the relationship between maternal obesity and CP in offspring[ 9 , 12 , 13 , 17 , 19 – 22 ], two studies showed that maternal weight during pregnancy is associated with CP in offspring[ 23 , 24 ], and other studies indicated a significant association between maternal obesity and CP in children[ 9 , 12 , 13 , 20 , 21 ]. Maternal obesity may contribute to CP in offspring via maternal preeclampsia, preterm birth, or a low Apgar score at 5 minutes (asphyxia), as these parameters alter the uterine environment[ 25 ] and lead to maladaptive programming of the fetal brain[ 26 ].…”

“…Furthermore, maternal obesity may induce a chronic inflammatory state, such as chorioamnionitis, which may contribute to the development of CP[ 15 ]. However, two studies[ 12 , 22 ] have reported that there is no significant association between maternal obesity and CP in children. The reason for this discrepancy may be that infants with CP whose mothers were not obese may have been affected by other factors that induce adverse neurodevelopmental outcomes.…”

Association Between Maternal Obesity and Cesarean Delivery Complications

“…Women with gestational diabetes have an increased risk of pregnancy complications; however, the risks are more in obese women with obese [9]. Another study by McPherson et al showed an increased risk of adverse delivery outcomes in the subgroup of morbidly obese women [10].…”