Impact of maternal pre-pregnancy body mass index on maternal, fetal and neonatal adverse outcomes in the worldwide populations: A systematic review and meta-analysis

Vats, Harsh; Saxena, Ruchi; Sachdeva, M.P.; Walia, Gagandeep Kaur; Gupta, Vipin

doi:10.1016/j.orcp.2021.10.005

Cited by 70 publications

(58 citation statements)

References 98 publications

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“…On the other hand, the association of pre-pregnancy overweight and obesity with maternal and neonatal adverse outcomes could lead to changes in altered maternal and neonatal physiology, as reported in the meta-analysis by Vats and colleagues 23 . They included 86 cohort studies of pregnant women and found that pre-pregnancy overweight and obese mothers were associated with cesarean delivery, emergency cesarean delivery, gestational diabetes, gestational hypertension, labor induction, postpartum hemorrhage, pre-eclampsia and pre-term premature rupture of membrane.…”

Section: Discussionmentioning

confidence: 99%

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Maternal pre-pregnancy body mass index and mental health problems in early adolescents from the 2004 Pelotas birth cohort

Quinte

Munhoz

Matijasevich

et al. 2022

Sci Rep

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Possible mechanisms by which maternal pre-pregnancy body mass index (BMI) programs offspring mental disorders in late childhood are not fully clarified. To assess the association between maternal BMI and mental health problems at 11 years old, we used data from the 2004 Pelotas birth cohort which comprised 4231 newborns. Maternal pre-pregnancy BMI was analyzed as underweight (< 18.5), normal (18.5–24.9), overweight (25.0–29.9), and obesity (≥ 30.0). Mental health problems were assessed at the child’s age of 11 years by the Strengths and Difficulties Questionnaire, total difficulties score and subscale scores (emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems), dichotomized into normal/borderline and abnormal category. The associations between maternal pre-pregnancy BMI and mental health problems in the whole sample and stratified by sex were estimated using crude and adjusted linear and logistic regression. Both linear and logistic regression showed that pre-pregnancy weight was associated with mental problems in early adolescents. Maternal pre-pregnancy obesity was associated with increased odds of total difficulty score among the whole sample. Boys whose mothers were pre-pregnancy overweight had higher odds of conduct problems (OR = 1.56; 95% CI: 1.13, 1.95), when compared to children of normal pre-pregnancy weight mothers, even after adjustments. Maternal pre-pregnancy obesity was associated with mental health problems in early adolescents; specifically, pre-pregnancy overweight increased the risk for conduct problems in 11 years old boys.

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Section: Discussionmentioning

confidence: 99%

“…The fetus and neonates of overweight and obese mothers have a higher risk for admission to the newborn intensive care unit, low APGAR score, large for gestational age, macrosomia, preterm birth. These adverse outcomes directly contribute to malprogramming 23 .…”

Section: Discussionmentioning

confidence: 99%

Maternal pre-pregnancy body mass index and mental health problems in early adolescents from the 2004 Pelotas birth cohort

Quinte

Munhoz

Matijasevich

et al. 2022

Sci Rep

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“…The risk of having a baby with a low Apgar score (defined as a five-minute Apgar score of less than 7) increases across the BMI classes, with women in obesity class III having the highest risk even after controlling for other risk factors. Furthermore, a systematic review conducted in 2015 revealed that maternal obesity was associated with low Apgar scores at five minutes and large for gestational age neonates, post-term delivery, and stillbirths [ 21 ]. This has implications for increased costs and duration of hospital stay for these high-risk newborns who require admission.…”

Section: Discussionmentioning

confidence: 99%

Increasing Pre-pregnancy Body Mass Index and Pregnancy Outcomes in the United States

Akinyemi¹,

Tanna²,

Adetokunbo³

et al. 2022

Cureus

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Introduction: As many Americans are becoming overweight or obese, increased body mass index (BMI) is fast becoming normalized. There is a need for more research that highlights the association between prepregnancy obesity and adverse pregnancy outcomes.Aim: To determine the association between increasing pre-pregnancy BMI and adverse pregnancy outcomes.Methods: We utilized the United States Vital Statistics records to collate data on all childbirths in the United States between 2015 and 2019. We determined the association between increasing pre-pregnancy BMI and adverse pregnancy outcomes using multivariate analysis. Neonatal outcomes measures include the fiveminute Apgar score, neonatal unit admission, neonates receiving assisted ventilation > six hours, neonatal antibiotics use, and neonatal seizures. Maternal outcomes include cesarean section rate, mothers requiring blood transfusion, unplanned hysterectomy, and intensive care unit admission. In addition, we controlled for maternal parameters such as race/ethnicity, age, insurance type, and pre-existing conditions such as chronic hypertension and prediabetes. Other covariates include paternal race, age and education level, gestational diabetes mellitus, induction of labor, weight gain during pregnancy, gestational age at delivery, and delivery weight.Results: We studied 15,627,572 deliveries in the US Vital Statistics records between 2015 and 2019. Among these women, 3.36% were underweight, 43.19% were with a normal BMI, 26.34% were overweight, 14.73% were in the obese class I, 7.23% were in the obese class II, and 5.14% were in the obese class III. Increasing pre-pregnancy BMI was associated with significant adverse outcomes across all measures of maternal and neonatal outcomes. Conclusion:A strong association exists between increasing pre-pregnancy BMI and adverse maternal and neonatal outcomes. The higher risk of adverse pregnancy outcomes among overweight and obese women remained even after controlling for other traditional risk factors of adverse maternal and neonatal outcomes.

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“…The association between increasing pre-pregnancy BMI and adverse neonatal outcomes is striking. Maternal pre-pregnancy BMI is strongly associated with infant mortality and other important outcomes, such as post-term birth and stillbirth (27). The risk of having a baby with a low Apgar score (de ned as 5-minute Apgar score of less than 7) increases across the BMI grade, with women with obese class III having the highest risk even after controlling for other risk factors.…”

Section: Discussionmentioning

confidence: 99%

Increasing Pre-Pregnancy Body Mass Index and Pregnancy Outcomes in the United States: Analysis of the US Vital Statistics Records (2015-2019)

Akinyemi¹,

Tanna

Adetokunbo

et al. 2022

Preprint

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Background: With 42% of adult Americans obese and 2/3rd of Americans overweight or obese, increased body mass index (BMI) is fast becoming normalized. There is a need to continue highlighting the association between pre-pregnancy obesity and adverse pregnancy outcomes in the country. The aim of the present study is to determine the association between increasing pre-pregnancy BMI and pregnancy outcomes.Methods: We utilized the United States Vital Statistics records to collate data on all childbirths in the United States between 2015 and 2019. We determined the association between increasing pre-pregnancy BMI and adverse pregnancy outcomes using multivariate analysis. Neonatal outcomes measures include the 5-min Apgar score, neonatal unit admission, neonates receiving assisted ventilation > 6 hours, neonatal antibiotics use, and neonatal seizures. Maternal outcomes include cesarean section rate, mothers requiring blood transfusion, unplanned hysterectomy, and intensive care unit admission. In addition, we controlled for maternal parameters such as race/ethnicity, age, insurance type, and preexisting conditions such as chronic hypertension, and prediabetes. Other covariates include paternal race, age and education level, gestational diabetes mellitus (GDM), induction of labor, weight gain during pregnancy, gestational age at delivery, and delivery weight. Results: We studied 15 627 572 deliveries in the US vital statistics records between 2015 and 2019. Among these women, 3.36% were underweight, 43.19% were with a normal BMI, 26.34% were overweight, 14.73% were in the obese class I, 7.23% were in the obese class II, and 5.14% in the obese class III. Increasing pre-pregnancy BMI was associated with significant adverse outcomes across all measures of maternal and neonatal outcomes. Conclusion: Increasing pre-pregnancy body mass index is associated with significant adverse pregnancy outcomes. Since pre-pregnancy BMI is a modifiable risk, women should be encouraged to lose weight before pregnancy to improve pregnancy outcomes.

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Impact of maternal pre-pregnancy body mass index on maternal, fetal and neonatal adverse outcomes in the worldwide populations: A systematic review and meta-analysis

Cited by 70 publications

References 98 publications

Maternal pre-pregnancy body mass index and mental health problems in early adolescents from the 2004 Pelotas birth cohort

Maternal pre-pregnancy body mass index and mental health problems in early adolescents from the 2004 Pelotas birth cohort

Increasing Pre-pregnancy Body Mass Index and Pregnancy Outcomes in the United States

Increasing Pre-Pregnancy Body Mass Index and Pregnancy Outcomes in the United States: Analysis of the US Vital Statistics Records (2015-2019)

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