Pre‐pregnant body mass index and recreational physical activity: effects on perinatal mortality in a prospective pregnancy cohort

Abstract

Objective To examine the effect of maternal pre-pregnant body mass index (BMI) and recreational physical activity on perinatal mortality. Design A prospective cohort study. Setting The Norwegian Mother and Child Cohort (MoBa), 1999-2008. Population Singleton pregnancies without congenital anomalies (n=77 246). Methods Pre-pregnant BMI was classified as underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9) and morbidly obese (BMI≥ 35). Risk estimates were obtained by logistic regression and adjusted for confounders. Main outcome measures Perinatal death (stillbirth ≥ 22 weeks plus early neonatal death 0-7 days after birth). Results An increased risk of perinatal death was seen in obese (odds ratio (OR) 2.4, 95% CI 1.7-3.4) and morbidly obese women (OR 3.3, 2.1-5.1), when compared to normal weight women. In the group participating in recreational physical activity during pregnancy, obese women had an OR of 3.2 (95% CI 2.2-4.7) for perinatal death relative to non-obese. In the non-active group the corresponding OR was 1.8 (95% CI 1.1-2.8) for obese women relative non-obese. The difference in perinatal mortality risk related to obesity between the active and non-active groups was statistically significant (p-value for interaction = 0.046, multiplicative model). Conclusions Maternal obesity was associated with a two- to three-fold increased risk of perinatal death when compared to normal weight women. For women with a BMI <30 the lowest perinatal mortality was seen in those performing recreational physical activity at least once a week.

Overweight in epilepsy as a risk factor for pregnancy and delivery complications

“…2 Such adjustment should be a prerequisite, as we show that women with epilepsy are more overweight than control women also in relation to pregnancy. 5 Exercise should be encouraged also in women with epilepsy, and especially during their childbearing years. Weight tends to increase with number of pregnancies, but there was no difference in parity in women with epilepsy compared to the nonepilepsy group.…”

“…For women with a BMI < 30, the lowest perinatal mortality was seen in those performing recreational physical activity at least once a week. 5 Exercise should be encouraged also in women with epilepsy, and especially during their childbearing years.…”

Association of Women's Reproductive History With Long-term Mortality and Effect of Socioeconomic Factors

“…Pre-pregnant high Body-Mass-Index (BMI) is associated with low education, and is inversely correlated to physical activity. (20) Low-education mothers are more likely to experience a complicated pregnancy. (21, 22) Women with gestational diabetes have a 7-fold increased risk of later type-2 diabetes.…”

Pregnant and active – suitability of the Pregnancy Physical Activity Questionnaire for measuring the physical activity of pregnant women in Poland

“…• none, less than 1/2 hour per day, 1/2 to almost 1 hour per day, 1 to almost 2 hours per day, 2 to almost 3 hours per day, 3 or more hours per day (questions: 4,5,6,7,8,9,10,11,14,15,16,19,20,21 ). Based on the average weekly energy expenditure, each of these activities was additionally classified by intensity: a) sedentary activity, b) light-intensity activity, c) moderate-intensity activity, d) vigorous-intensity activity.…”

“…One of benefits of physical activity during pregnancy is a reduced risk of gestational diabetes [13]; nevertheless, the level of knowledge in Polish women about gestational diabetes is still insufficient [14]. Physical activity helps control body mass and prevents obesity [15], which increases perinatal mortality [16]. Additionally, physically active women tend to experience fewer side effects of pregnancy, such as insomnia, anxiety and somatic symptoms (e.g.…”