Maternal pre‐pregnancy underweight as a risk factor for the offspring: Survey of Neonates in Pomerania

Lange, Anja; Ittermann, Till; Fallenberg, Jonas; Allenberg, Heike; Zygmunt, Marek; Heckmann, Matthias

doi:10.1111/apa.15701

Cited by 6 publications

(10 citation statements)

References 32 publications

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“…Socio-economic factors included educational level, professional status and income of pregnant women and the partner/huesband. The stratification pattern for educational level followed previously published patterns [ 28 , 29 ]. Persons being still at school, without school diploma, or with five years or less of secondary school, were grouped as having a lower educational level.…”

Section: Methodssupporting

confidence: 55%

“…According to the classification recommended by WHO [ 30 ] women were categorized into different BMI groups. Following previously published patterns [ 28 , 29 ], this study used a dichotomous classification for the information on smoking and alcohol consumption: ‘smoker/non-smoker’ and ‘drinker/non-drinker’. A pregnant woman was classified as a smoker if she declared to smoke during the last four weeks before delivery.…”

Section: Methodsmentioning

confidence: 99%

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Antenatal Care and Health Behavior of Pregnant Women—An Evaluation of the Survey of Neonates in Pomerania

et al. 2023

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Background. The German maternity guidelines require regular medical checkup (MC) during pregnancy as a measure of prevention. Socioeconomic factors such as education, profession, income and origin, but also age and parity may influence the preventive and health behavior of pregnant women. The aim was to investigate the influence of these factors on the participation rate in MC of pregnant women. Method. The current analysis is based on the prospective population-based birth cohort study Survey of Neonates in Pomerania, which was conducted in Western Pomerania, Germany. The data of 4092 pregnant women from 2004 to 2008 were analyzed regarding the antenatal care and health behavior. Up to 12 MC were regularly offered; participation in 10 MC is defined as standard screening according to maternity guidelines. Results. Women participated in the first preventive MC on average in the 10th (±3.8 SD) week of pregnancy. 1343 (34.2%) women participated in standard screening and 2039 (51.9%) took a screening above standard. 547 (13.92%) women participated in less than the 10 standard MCs. In addition, about one-third of the pregnancies investigated in this study were unplanned. Bivariate analyses showed an association between better antenatal care behavior and higher maternal age, stabile partnerships and mother born in Germany, p < 0.05. On the contrary antenatal care below standard were more often found by women with unplanned pregnancies, less educational women and women with lower equivalent income, p < 0.001. Health behaviors also influenced antenatal care. Whereas the risk of antenatal care below standard increased by smoking during pregnancy (RRR 1.64; 95% CI 1.25, 2.14) and alcohol consumption (RRR 1.31; 95% CI 1.01, 1.69), supplementation intake was associated with decreased risk (iodine—RRR 0.66; 95% CI 0.53, 0.81; folic acid—RRR 0.56; 95% CI 0.44, 0.72). The health behavior of pregnant women also differs according to their social status. Higher maternal income was negatively correlated with smoking during pregnancy (OR 0.2; 95% CI 0.15, 0.24), but positively associated with alcohol consumption during pregnancy (OR 1.3; 95% CI 1.15, 1.48) and lower pre-pregnancy BMI (Coef. = 0.083, p < 0.001). Lower maternal education was positively correlated with smoking during pregnancy (OR 59.0; 95% CI 28.68, 121.23). Conclusions. Prenatal care according to maternity guidelines is well established with a high participation rate in MC during pregnancy of more than 85%. However, targeted preventive measures may address younger age, socioeconomic status and health-damaging behaviors (smoking, drinking) of the pregnant women because these factors were associated with antenatal care below standard.

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Section: Methodssupporting

confidence: 55%

Section: Methodsmentioning

confidence: 99%

Antenatal Care and Health Behavior of Pregnant Women—An Evaluation of the Survey of Neonates in Pomerania

et al. 2023

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“…All covariates were examined as possible confounders based on their potential to impact on maternal and neonatal outcomes as described in the literature. 9,17,22,35,46 Similarly, other confounders were adjusted for based on their known impact on maternal and neonatal outcomes. These included maternal medical conditions (pre-existing diabetes mellitus, 47 gestational diabetes mellitus, 48 hypertension, 49 pre-eclampsia, 50 eclampsia 51 ), country of birth 52 (dichotomised as 'Australia [and territories]' and 'other'), birth type (dichotomised as 'caesarean birth -any type' [including elective or emergency caesarean] and 'vaginal birth -any type' [including normal vaginal or instrumental]), gestation (dichotomised as 'greater than or equal to 37 weeks' or 'preterm') and parity 53 (dichotomised as 'nullipara' and 'multipara').…”

Section: Confoundersmentioning

confidence: 99%

“…Living in areas of high deprivation, 1,6 rural residency, 1,7 adolescent pregnancy 8–11 and being unpartnered 9,12 are all associated with social disadvantage. Other factors associated with disadvantage and deprivation that can further impact adversely on women's health and well‐being include smoking, 4 obesity (body mass index [BMI] ≥30 kg/m 2 ) 13–16 or being underweight (BMI <18.5 kg/m 2 ) 13,17 …”

Section: Introductionmentioning

confidence: 99%

“…Other factors associated with disadvantage and deprivation that can further impact adversely on women's health and well-being include smoking, 4 obesity (body mass index [BMI] ≥30 kg/m 2 ) [13][14][15][16] or being underweight (BMI <18.5 kg/m 2 ). 13,17 Disadvantaged women are consistently overrepresented in the data for adverse maternal and neonatal outcomes such as maternal admission to intensive care unit (ICU), 18 postpartum haemorrhage (PPH), 19 preterm birth, low birthweight 9,20 and stillbirth. [21][22][23] Deprivation, 20 stress 24,25 and low engagement with pregnancy care 26,27 contribute to these outcomes.…”

mentioning

confidence: 99%

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Perinatal outcomes of socially disadvantaged women in Australia: A population‐based retrospective cohort study

Faulks

Shafiei

McLachlan

et al. 2023

BJOG

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ObjectiveTo examine the perinatal outcomes of women who experience social disadvantage using population‐based perinatal data collected between 1999 and 2016.DesignPopulation‐based, retrospective cohort study.SettingVictoria, Australia.Population or SampleA total of 1 188 872 singleton births were included.MethodsCohort study using routinely collected perinatal data. Multiple logistic regression was performed to determine associations between social disadvantage and adverse maternal and neonatal outcomes with confidence limits set at 99%. Time‐trend analysis for perinatal outcomes was performed in relation to area‐level disadvantage measures.Main Outcome MeasuresIncidence of maternal admission to intensive care unit (ICU), postpartum haemorrhage (PPH) and caesarean section, perinatal mortality, preterm birth, low birthweight (LBW), and admission to special care nursery/neonatal intensive care unit (SCN/NICU).ResultsSocial disadvantage was associated with higher odds of adverse perinatal outcomes. Disadvantaged women were more likely to be admitted to ICU, have a PPH or experience perinatal mortality (stillbirth or neonatal death) and their neonates were more likely to be admitted to SCN/NICU, be born preterm and be LBW. A persistent social gradient existed across time for the most disadvantaged women for all outcomes except caesarean section.ConclusionsSocial disadvantage has a marked negative impact on perinatal outcomes. This aligns with national and international evidence regarding the impact of disadvantage. Strategies that improve access to, and reduce fragmentation in, maternity care in addition to initiatives that address the social determinants of health may contribute to improving perinatal outcomes for socially disadvantaged women.

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Maternal socioeconomic and lifestyle factors and life dissatisfaction associated with a small for gestational age infant. The Survey of Neonates in Pomerania (SNiP)

Pierdant

Ittermann

Freyer‐Adam

et al. 2022

Arch Gynecol Obstet

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Purpose The aim is to investigate the associations of the mother’s socioeconomic and lifestyle factors and life satisfaction with the delivery of a small for gestational age (SGA) infant. Methods Data from 4598 participants of the population-based birth cohort study Survey of Neonates in Pomerania (SniP) including comprehensive information on pregnancies, mothers, and their offspring in Western Pomerania, Germany were used in this study. The associations were analyzed using linear and logistic regression models. Results After logistic regression analysis adjusted for height of the mother, women who delivered SGA infants, had lower education (p < 0.01) and smoked more frequently during pregnancy (p < 0.01) compared with mothers of adequate for gestational age (AGA) neonates. A mother with less than 10 years of education and one who continued smoking during pregnancy had an odds ratio (OR) of 2.23 [95% confidence interval (CI) = 1.44 to 3.46] and 2.68 (95% CI = 2.06–3.49) of having an SGA infant, respectively. There was no association between the employment of the mother (p = 0.28), the monthly income (p = 0.09), the family status (p = 0.80), the number of friendships outside the household that the mother would not wish to relinquish (p = 0.47), the number of people that she could rely on in case of an emergency (p = 0.75), or alcohol consumption prior to (p = 0.14) or during the pregnancy (p = 0.99) with SGA. Finally, women who delivered SGA infants were more frequently dissatisfied with their employment (p = 0.03) and financial status (p < 0.01). Conclusions Women who delivered SGA infants had more associated socioeconomic and lifestyle risk factors and were more frequently dissatisfied with their life conditions than mothers of AGA neonates.

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Maternal pre‐pregnancy underweight as a risk factor for the offspring: Survey of Neonates in Pomerania

Cited by 6 publications

References 32 publications

Antenatal Care and Health Behavior of Pregnant Women—An Evaluation of the Survey of Neonates in Pomerania

Antenatal Care and Health Behavior of Pregnant Women—An Evaluation of the Survey of Neonates in Pomerania

Perinatal outcomes of socially disadvantaged women in Australia: A population‐based retrospective cohort study

Maternal socioeconomic and lifestyle factors and life dissatisfaction associated with a small for gestational age infant. The Survey of Neonates in Pomerania (SNiP)

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