The University of Southampton
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Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of Europe, North American and Australian cohorts

Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of Europe, North American and Australian cohorts
Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of Europe, North American and Australian cohorts
Objective
To assess the separate and combined associations of maternal pre‐pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact.

Design
Individual participant data meta‐analysis of 39 cohorts.

Setting
Europe, North America, and Oceania.

Population
265 270 births.

Methods
Information on maternal pre‐pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used.

Main outcome measures
Gestational hypertension, pre‐eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth.

Results
Higher maternal pre‐pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31– 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain.

Conclusions
Maternal pre‐pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre‐pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity.

Tweetable abstract
Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.
1470-0328
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Voerman, Ellis
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Amiano, Pilar
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Santos, Susana G., Voerman, Ellis, Amiano, Pilar, Barros, Henrique, Beilin, Lawrence J, Bergström, Anna, Charles, Marie-Aline, Chatzi, Leda, Chevrier, Cecile, Chrousos, George P., Corpeleijn, Eva, Costa, Olga, Costet, Nathalie, Crozier, Sarah, Devereux, Graham, Doyon, Myriam, Eggesbø, Merete, Fantini, Maria Pia, Farchi, Sara, Forastiere, Francesco, Georgiu, Vagelis, Godfrey, Keith, Gori, Davide, Grote, Veit, Hanke, Wojciech, Hertz-Picciotto, Irva, Heude, Barbara, Hivert, Marie-France, Hryhorczuk, Daniel O., Huang, Rae-Chi, Inskip, Hazel, Karvonen, Anne M., Kenny, Louise C., Koletzko, Berthold, Küpers, Leanne K., Lagstrom, Hanna, Lehmann, Irina, Magnus, Per, Majewska, Renata, Makela, Johanna, Manios, Yannis, McAuliffe, Fionnuala M., McDonald, Sheila W., Mehegan, John, Melén, Erik, Mommers, Monique, Morgen, Camilla S, Moschonis, George, Murray, Deirdre, Chaoimh, Carol Ni, Nohr, Ellen Aagaard, Nybo Andersen, Anne-Marie, Oken, Emily, Oostvogels, Adriette J J M., Pac, Agnieszka, Papadopoulou, Eleni, Pekkanen, Juha, Pizzi, Costanza, Polanska, Kinga, Porta, Daniela, Richiardi, Lorenzo, Rifas-shiman, Sheryl L., Roeleveld, Nel, Ronfani, Luca, Santos, Ana C., Standl, Marie, Stigum, Hein, Stoltenberg, Camilla, Thiering, Elisabeth, Thijs, Carel, Torrent, Maties, Tough, Suzanne C., Trnovec, Tomas, Turner, Steve, van Gelder, Marleen M. H. J., van Rossem, Lenie, von Berg, Andrea, Vrijheid, Martine, Vrijkotte, Tanja G. M. and West, Jane (2019) Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of Europe, North American and Australian cohorts. BJOG: An International Journal of Obstetrics & Gynaecology, 126 (8), 984-995. (doi:10.1111/1471-0528.15661).

Record type: Article

Abstract

Objective
To assess the separate and combined associations of maternal pre‐pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact.

Design
Individual participant data meta‐analysis of 39 cohorts.

Setting
Europe, North America, and Oceania.

Population
265 270 births.

Methods
Information on maternal pre‐pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used.

Main outcome measures
Gestational hypertension, pre‐eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth.

Results
Higher maternal pre‐pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31– 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain.

Conclusions
Maternal pre‐pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre‐pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity.

Tweetable abstract
Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.

Text
IPD meta-analysis pregnancy complications - Accepted Manuscript
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More information

Accepted/In Press date: 6 February 2019
e-pub ahead of print date: 20 February 2019
Published date: July 2019

Identifiers

Local EPrints ID: 431980
URI: http://eprints.soton.ac.uk/id/eprint/431980
ISSN: 1470-0328
PURE UUID: d1974343-281d-49d6-b9b5-dfff97771da1
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618
ORCID for Hazel Inskip: ORCID iD orcid.org/0000-0001-8897-1749

Catalogue record

Date deposited: 25 Jun 2019 16:30
Last modified: 15 Sep 2021 04:34

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Contributors

Author: Susana G. Santos
Author: Ellis Voerman
Author: Pilar Amiano
Author: Henrique Barros
Author: Lawrence J Beilin
Author: Anna Bergström
Author: Marie-Aline Charles
Author: Leda Chatzi
Author: Cecile Chevrier
Author: George P. Chrousos
Author: Eva Corpeleijn
Author: Olga Costa
Author: Nathalie Costet
Author: Sarah Crozier ORCID iD
Author: Graham Devereux
Author: Myriam Doyon
Author: Merete Eggesbø
Author: Maria Pia Fantini
Author: Sara Farchi
Author: Francesco Forastiere
Author: Vagelis Georgiu
Author: Keith Godfrey ORCID iD
Author: Davide Gori
Author: Veit Grote
Author: Wojciech Hanke
Author: Irva Hertz-Picciotto
Author: Barbara Heude
Author: Marie-France Hivert
Author: Daniel O. Hryhorczuk
Author: Rae-Chi Huang
Author: Hazel Inskip ORCID iD
Author: Anne M. Karvonen
Author: Louise C. Kenny
Author: Berthold Koletzko
Author: Leanne K. Küpers
Author: Hanna Lagstrom
Author: Irina Lehmann
Author: Per Magnus
Author: Renata Majewska
Author: Johanna Makela
Author: Yannis Manios
Author: Fionnuala M. McAuliffe
Author: Sheila W. McDonald
Author: John Mehegan
Author: Erik Melén
Author: Monique Mommers
Author: Camilla S Morgen
Author: George Moschonis
Author: Deirdre Murray
Author: Carol Ni Chaoimh
Author: Ellen Aagaard Nohr
Author: Anne-Marie Nybo Andersen
Author: Emily Oken
Author: Adriette J J M. Oostvogels
Author: Agnieszka Pac
Author: Eleni Papadopoulou
Author: Juha Pekkanen
Author: Costanza Pizzi
Author: Kinga Polanska
Author: Daniela Porta
Author: Lorenzo Richiardi
Author: Sheryl L. Rifas-shiman
Author: Nel Roeleveld
Author: Luca Ronfani
Author: Ana C. Santos
Author: Marie Standl
Author: Hein Stigum
Author: Camilla Stoltenberg
Author: Elisabeth Thiering
Author: Carel Thijs
Author: Maties Torrent
Author: Suzanne C. Tough
Author: Tomas Trnovec
Author: Steve Turner
Author: Marleen M. H. J. van Gelder
Author: Lenie van Rossem
Author: Andrea von Berg
Author: Martine Vrijheid
Author: Tanja G. M. Vrijkotte
Author: Jane West

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