Prepregnancy body mass index is an independent risk factor for gestational hypertension, gestational diabetes, preterm labor, and small- and large-for-gestational-age infants

Shin, Dayeon; Song, Won O.

doi:10.3109/14767058.2014.964675

Cited by 161 publications

(140 citation statements)

References 23 publications

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“…2 The annual societal economic costs associated with PTB are enormous. A large number of independent causes can contribute to PTB, such as intrauterine infection, low prepregnancy body mass index (BMI), and multiple gestation, [3][4][5] but the etiology of PTB is still not fully understood, and there remain many risk factors still to be identified.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D and risk of preterm birth: Up‐to‐date meta‐analysis of randomized controlled trials and observational studies

Zhou

Tao

Huang

et al. 2017

J of Obstet and Gynaecol

107

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Aim: We performed a meta-analysis of randomized controlled trials (RCT) and observational studies to answer the two following questions: (i) whether low maternal circulating 25 hydroxyvitamin D (25-OHD) is associated with an increased risk of preterm birth (PTB) or spontaneous PTB (sPTB); and (ii) whether vitamin D supplementation alone during pregnancy can reduce the risk of PTB. Methods: Literature search was carried out using Pubmed, Web of Science and Embase databases up to June 2016. Pooled OR or relative risk (RR) with 95%CI were computed using fixed or random effects models depending on the size of heterogeneity. Subgroup analysis was used to explore potential sources of between-study heterogeneity. Publication bias was evaluated using Egger's test and Begg's test. Results: Twenty-four articles (six RCT and 18 observational studies) were identified. Maternal circulating 25-OHD deficiency (pooled OR, 1.25; 95%CI: 1.13-1.38) rather than insufficiency (pooled OR, 1.09; 95%CI: 0.89-1.35) was associated with an increased risk of PTB, and vitamin D supplementation alone during pregnancy could reduce the risk of PTB (pooled RR, 0.57; 95%CI: 0.36-0.91). This was also the case for the sPTB subgroup (circulating 25-OHD <50 vs >50 nmol/L; pooled OR, 1.45; 95%CI: 1.20-1.75). Conclusions: Maternal circulating 25-OHD deficiency could increase PTB risk and vitamin D supplementation alone during pregnancy could reduce PTB risk. Extrapolation of the results, however, must be done with caution, and there is urgent need for larger, better-designed RCT to confirm this effect.

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Section: Introductionmentioning

confidence: 99%

Vitamin D and risk of preterm birth: Up‐to‐date meta‐analysis of randomized controlled trials and observational studies

Zhou

Tao

Huang

et al. 2017

J of Obstet and Gynaecol

107

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show abstract

“…Some research suggests that obese women may also be at risk for SGA infants as well, however, this finding is not consistent among studies. 53,54 Suggested pathways for this relationship include increased risk of gestational hypertension and diabetes among obese women, which can lead to alterations in placental development and perfusion that lead to altered nutrient transmission to the growing fetus. 60 Rates of SGA births among obese women have been estimated at 5.7% to 7.5%.…”

Section: Maternal Outcomesmentioning

confidence: 98%

“…20,51 Not surprising, obese women are also at two to three times higher risk for delivering an LGA infant, with delivery rates for LGA infants between 16% and 22% in some studies. 23,51,53 The risk of LGA birth may be exacerbated by excessive gestational weight gain. 53 Shoulder dystocia, which occurs when the infant's head is delivered but the shoulders become obstructed in the birth canal, results in a slow, difficult labor that may result in fetal neural injuries, fetal hypoxia, and higher risk of maternal hemorrhage.…”

Section: Maternal Outcomesmentioning

confidence: 99%

“…49 Women who are obese before pregnancy are at a significantly elevated risk for preterm delivery. 23,[50][51][52][53][54] Preterm delivery risk may follow an obesity gradient. A population-based cohort study of >226,000 women found that 8.4% of women with class I obesity, 8.8% with class II obesity, and 10.3% with class III obesity delivered preterm, compared to 7.1% of women who began pregnancy with BMI 25.…”

Section: Maternal Outcomesmentioning

confidence: 99%

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Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes

Stang

Huffman

2016

Journal of the Academy of Nutrition and Dietetics

147

131

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It is the position of the Academy of Nutrition and Dietetics that all women of reproductive age receive education about maternal and fetal risks associated with prepregnancy obesity, excessive gestational weight gain, and significant postpartum weight retention, including potential benefits of lifestyle changes. Behavioral counseling to improve dietary intake and physical activity should be provided to overweight and obese women, beginning in the preconception period and continuing throughout pregnancy, for at least 12 to 18 months postpartum. Weight loss before pregnancy may improve fertility and reduce the risk of poor maternal-fetal outcomes, such as preterm birth, gestational diabetes, gestational hypertension, pre-eclampsia, assisted delivery, and select congenital anomalies. Lifestyle interventions that moderate gestational weight gain may reduce the risk of poor pregnancy outcomes, such as gestational diabetes, gestational hypertension, large for gestational age, and macrosomia, as well as lower the risk for significant postpartum retention. Postpartum interventions that promote healthy diet and physical activity behaviors may reduce postpartum weight retention and decrease obesity-related risks in subsequent pregnancies. Analysis of the evidence suggests that there is good evidence to support the role of diet, physical activity, and behavior changes in promoting optimal weight gain during pregnancy; however, there is currently a relative lack of evidence in other areas related to reproductive outcomes.

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“…The cross sectional association between body mass index (BMI) and GDM is well established [5]. Although evidence of a causal relationship is scarce, in a meta-analysis of observational studies, the risk of development of GDM ranged from a two-to fivefold increase for women who were overweight and severely obese prior to pregnancy, respectively [6].…”

Section: Introductionmentioning

confidence: 99%

Pre-pregnancy weight change and incidence of gestational diabetes mellitus: A finding from a prospective cohort study

Adane

Tooth

Mishra

2017

Diabetes Research and Clinical Practice

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Aims: In a population-based cohort study we examined the associations between early adult pre-pregnancy weight change and the risk of gestational diabetes mellitus (GDM). Methods:The study included 3,111 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health. These women have been surveyed regularly since 1996. Women without diabetes and GDM were followed-up between 2003 and 2012.Generalized estimating equations were used to assess the effect of baseline (1996, mean age 20 years) and pre-pregnancy body mass index (BMI) and the pre-pregnancy weight changes on the incidence of GDM. The full models were adjusted for sociodemographic and lifestyle factors.Results: From 2003-2012, 229 GDM cases (4.4%) were reported in 5,242 pregnancies.Relative to normal BMI women, obese women at baseline (RR: 1.8, 95% CI: 1.1, 2.8) and prior to pregnancy (RR: 2.7, 95% CI: 2.0, 3.6) were at greater risk of GDM. Weight gains prior to each study pregnancy were strongly associated with increased GDM risk with an adjusted RR ranging from 2.0 to 2.9. Within under/normal range of BMI, women with a moderate/high (>2.5%/year) weight gain had 2.7 (95% CI: 1.3, 5.5) times the risk of GDM compared with women with stable weight. Conclusions:Early adult weight gain, even within normal BMI range, is an important risk factor for the development of GDM. Weight gain prevention from early adulthood to prior to pregnancy appears to be the main strategy to prevent the incidence of GDM.

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Prepregnancy body mass index is an independent risk factor for gestational hypertension, gestational diabetes, preterm labor, and small- and large-for-gestational-age infants

Cited by 161 publications

References 23 publications

Vitamin D and risk of preterm birth: Up‐to‐date meta‐analysis of randomized controlled trials and observational studies

Vitamin D and risk of preterm birth: Up‐to‐date meta‐analysis of randomized controlled trials and observational studies

Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes

Pre-pregnancy weight change and incidence of gestational diabetes mellitus: A finding from a prospective cohort study

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