Prepregnancy body mass index and cardiovascular disease mortality: The child health and development studies

Abstract

Objective Overweight early in life may contribute to cardiovascular disease mortality through progression to later life obesity or through a cumulative effect of excess weight. Few studies have investigated the relationship between body mass index (BMI) before middle age and cardiovascular disease mortality in women. Using the Child Health and Development Studies cohort of 11,006 pregnant women recruited between 1959 and 1967, we tested the hypothesis that higher self-reported pre-pregnancy BMI is associated with increased stroke and coronary heart disease mortality. Design and Methods Cause of death was assessed annually from enrollment through 2007 by linking with California Vital Status Records. We calculated Cox proportional hazards ratios for cause-specific mortality for each BMI category. Results Median follow-up was 37 years with 1,839 participant deaths at a mean age of 64.1 years. At higher levels of BMI, participants were older, had higher prevalence of co-morbid conditions, higher parity, and lower family income. In adjusted models, women with higher pre-pregnancy BMI had increased coronary heart disease mortality compared to those with normal BMI. Women who were underweight, overweight, or obese had higher all-cause mortality. Sensitivity analyses confirmed these results. Conclusions Pre-pregnancy BMI has a monotonic association with coronary heart disease mortality and a j-shaped association with non-cardiovascular mortality.

Gestational Weight Gain and Health Outcomes 18 Years Later in Urban Black Women

“…Women in this highest obesity category are at risk for multiple health problems and their pre-pregnancy BMI is associated with CVD and all-cause mortality regardless of GWG (40). Analyses were also repeated including the intervention as a covariate, because nurse home visitors encouraged healthy eating, which potentially could affect GWG and other health behaviors.…”

The accuracy of self‐reported pregnancy‐related weight: a systematic review

“…Most studies (62.9%) were conducted in the United States. Over half (61.3%) of populations were racially and ethnically heterogeneous . Cohorts represented births from 1959 to 2013 and length of recall ranged from three days to 32 years in the past .…”

Maternal Obesity During Pregnancy Associates With Premature Mortality and Major Cardiovascular Events in Later Life

“…6 The Child Health and Development Studies Cohort had fewer years of follow-up, relied on self-reported prepregnancy BMI, and included a significant proportion of multiparous women. In our primary analysis, we selected only those women with BMI measured at their first pregnancy.…”

“…6 The study included multiparous women, which may have introduced bias because of cumulative weight gain with increasing parity. 7 In addition, self-reported BMI is notoriously Abstract-One in 5 pregnant women is obese but the impact on later health is unknown.…”