Risk of adverse pregnancy outcomes by pre-pregnancy Body Mass Index among Italian population: a retrospective population-based cohort study on 27,807 deliveries

Masturzo, Bianca; Franzè, Vera; Germano, Chiara; Attini, Rossella; Gennarelli, Gianluca; Lezo, Antonella; Rolfo, Alessandro; Plazzotta, Claudio; Brunelli, Elena; Youssef, A.; Todros, Tullia; Farina, Antonio

doi:10.1007/s00404-019-05093-0

Cited by 20 publications

(29 citation statements)

References 30 publications

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“…Being underweight was considered as a risk factor for preterm birth before 32 weeks, rather than being overweight or obese (47,48). Maternal complications, such as GDM, PE, and postpartum hemorrhage, were reported to be associated with high pre-pregnancy BMI (49,52). In our study, pre-pregnancy BMI was not associated with preterm birth at 32, 34, and 37 weeks of gestation.…”

Section: Discussionmentioning

confidence: 43%

Perinatal Outcomes and Risk Factors for Preterm Birth in Twin Pregnancies in a Chinese Population: A Multi-center Retrospective Study

Gao

Liu

et al. 2021

Front. Med.

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Background: Twin pregnancies are associated with an increased risk of adverse maternal and neonatal outcomes, mainly owing to prematurity. Few studies have evaluated the risk factors for preterm birth (PTB) in Chinese population. The objective of this study is to present the short-term maternal-neonatal outcomes, investigating the potential risk factors associated with preterm birth in Chinese twin pregnancies.Methods: A multi-center retrospective study of women pregnant with twins ≥28 weeks of gestation was conducted. Maternal and neonatal outcomes were analyzed. Logistic regression was used to identify potential risk factors for PTB before 37, 34, and 32 weeks, respectively.Results: A total of 3,288 twin pregnancies and 6,576 neonates were included in 99,585 pregnancies. The rate of twin pregnancy was 3.3%, while the PTB rate before 37, 34, and 32 weeks among this population were 62.1, 18.8, and 10.4%, respectively. Logistic regression revealed that monochorionicity [Odds ratio (OR) 3.028, 95% confident interval (CI) 2.489–3.683, P < 0.001], gestational weight gain (GWG) <10 kg (OR 2.285, 95% CI 1.563–3.339, P < 0.001) and GWG between 10 and 15 kg (OR 1.478, 95% CI 1.188–1.839, P < 0.001), preeclampsia (PE) (OR 3.067, 95% CI 2.142–4.390, P < 0.001), and intrahepatic cholestasis of pregnancy (ICP) (OR 3.122, 95% CI 2.121–4.596, P < 0.001) were the risk factors for PTB before 37 weeks. Monochorionicity (OR 2.865, 95% CI 2.344–3.501, P < 0.001), age < 25 years (OR 1.888, 95% CI 1.307–2.728, P = 0.001), and GWG <10 kg (OR 3.100, 95% CI 2.198–4.372, P < 0.001) were risk factors for PTB before 34 weeks. Monochorionicity (OR 2.566, 95% CI 1.991–3.307, P < 0.001), age younger than 25 years (OR 1.964, 95% CI 1.265–3.048, P = 0.003), and GWG <10 kg (OR 4.319, 95% CI 2.931–6.364, P < 0.001) were the risk factors for PTB before 32 weeks.Conclusions: Monochorionicity and GWG <10 kg were two major risk factors for PTB before 32, 34, and 37 weeks, whereas maternal age, PE, and ICP were also risk factors for PTB in specific gestational age.

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Section: Discussionmentioning

confidence: 43%

Perinatal Outcomes and Risk Factors for Preterm Birth in Twin Pregnancies in a Chinese Population: A Multi-center Retrospective Study

Gao

Liu

et al. 2021

Front. Med.

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“…Maternal overweight and obesity are associated with an increased risk of many adverse perinatal outcomes, such as preterm birth, gestational diabetes, gestational hypertension (GHTN), preeclampsia, cesarean delivery and macrosomia [4][5][6][7][8][9][10][11][12]. However, the previous epidemiological studies are mainly from Western countries [4][5][6][7][8][9][10][11][12][13][14]. The prevalence of overweight and obesity is quite different among races and ethnicities, and there might be different effects on the risk of perinatal complications.…”

Section: Introductionmentioning

confidence: 99%

Maternal Prepregnancy Body Mass Index, Gestational Weight Gain, and Risk of Adverse Perinatal Outcomes in Taiwan: A Population-Based Birth Cohort Study

Chen

Hsu

2020

IJERPH

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Epidemiological studies have shown that maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) are associated with increased risk of perinatal outcomes. However, the evidence of such associations in Asian populations is limited. We conducted a secondary data analysis to investigate the relationships of prepregnancy BMI and GWG with the risks of adverse perinatal outcomes, including gestational diabetes (GDM), gestational hypertension (GHTN), preeclampsia, cesarean delivery, preterm birth, low birth weight (LBW), and macrosomia. We categorized prepregnancy BMI by the WHO classification and GWG by the Institute of Medicine guidelines. We performed adjusted logistic regression models to estimate the odds ratios of adverse perinatal outcomes. A total of 19,052 women were included; prepregnancy overweight and obesity were associated with a greater risk of GDM, GHTN, preeclampsia, cesarean delivery, preterm birth, and macrosomia. Women with excessive GWG had a greater risk of GHTN, preeclampsia, cesarean delivery, and macrosomia. In conclusion, regardless of the range of GWG during pregnancy, maternal prepregnancy BMI is significantly associated with the risk of adverse perinatal outcomes in Taiwan. Public health attention regarding obesity reduction before conception and prenatal counseling for optimal GWG is needed to mitigate the risk of poor perinatal outcomes.

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“…Maternal pre-pregnancy overweight and obesity are reportedly linked with the hazards of poor maternal and neonatal consequences, such as preterm birth (PTB), gestational diabetes, and cesarean delivery. [2][3][4][5] In addition to maternal pre-pregnancy obesity, unsuitable gestational weight gain (GWG) may profoundly impact mother-infant…”

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confidence: 99%

Maternal pre‐pregnancy body mass index, gestational weight gain trajectory, and risk of adverse perinatal outcomes

Miao

et al. 2021

Intl J Gynecology & Obste

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Objective To evaluate the relationships of pre‐pregnancy body mass index (BMI) and gestational weight gain (GWG) trajectory with adverse perinatal outcomes (APOs). Methods A retrospective cohort study was conducted in China, and 12 855 women who had a singleton birth were included. The WHO classification categorized pre‐pregnancy BMI, and five GWG trajectories were identified using the latent class growth model. Results The adjusted odds ratios for the risks of cesarean delivery, preterm birth, and large‐for‐gestational‐age (LGA) infant were significantly higher in women with whoe were overweight or obese pre‐pregnancy, but were lower in underweight (except preterm birth) than in normal weight women. Five GWG trajectories were identified: (1) retaining GWG (6.6 kg), (2) moderately slow GWG (10.5 kg), (3) moderate GWG (13.7 kg), (4) moderately fast GWG (16.3 kg), and (5) rapid GWG (19.8 kg). Compared with women in trajectory 3, the risks of cesarean delivery and LGA increase by about 35%–96% for the women in trajectory 4 or 5, whereas the women in trajectory 1 or 2 are inclined to have a higher risk of small for gestational age, but lower risk of LGA. Association of GWG trajectory with APOs varies across pre‐pregnancy BMI subgroups. Conclusion This study highlights the influence of inappropriate pre‐pregnancy maternal weight and GWG trajectories on the risk of APOs.

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Risk of adverse pregnancy outcomes by pre-pregnancy Body Mass Index among Italian population: a retrospective population-based cohort study on 27,807 deliveries

Cited by 20 publications

References 30 publications

Perinatal Outcomes and Risk Factors for Preterm Birth in Twin Pregnancies in a Chinese Population: A Multi-center Retrospective Study

Perinatal Outcomes and Risk Factors for Preterm Birth in Twin Pregnancies in a Chinese Population: A Multi-center Retrospective Study

Maternal Prepregnancy Body Mass Index, Gestational Weight Gain, and Risk of Adverse Perinatal Outcomes in Taiwan: A Population-Based Birth Cohort Study

Maternal pre‐pregnancy body mass index, gestational weight gain trajectory, and risk of adverse perinatal outcomes

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