Fetal and perinatal consequences of maternal obesity

Vasudevan, Chakrapani; Renfrew, Mary J; McGuire, William

doi:10.1136/adc.2009.170928

Cited by 103 publications

(81 citation statements)

References 46 publications

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“…Maternal obesity is associated with multiple complications of pregnancy 51 and with perinatal mortality. [52][53][54][55] Perhaps most relevant to our study is the association with fetal growth restriction. 19,56 In addition, obesity is linked to chronic illnesses 57,58 and social disadvantage, 59 which might affect the mother-infant interaction and the resources available to enhance the home environment.…”

Section: Discussionmentioning

confidence: 99%

Antenatal Antecedents of Cognitive Impairment at 24 Months In Extremely Low Gestational Age Newborns

et al. 2012

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WHAT'S KNOWN ON THIS SUBJECT: Among extremely premature infants, survival has improved, but the rate of cognitive impairment has not. Impaired cognition is the most frequent developmental problem identified in survivors. Several antenatal factors have been associated with cognitive impairment, mostly related to social disadvantage. WHAT THIS STUDY ADDS:In addition to social disadvantage, antenatal characteristics associated with cognitive impairment include maternal obesity and thrombosis of fetal stem vessels. Prenatal infection and inflammation were not associated with impaired early cognitive function among extremely preterm infants. abstract BACKGROUND AND OBJECTIVES: Extremely low gestational age neonates are more likely than term infants to develop cognitive impairment. Few studies have addressed antenatal risk factors of this condition. We identified antenatal antecedents of cognitive impairment determined by the Mental Development Index (MDI) portion of the Bayley Scales of Infant Development, Second Edition (BSID-II), at 24 months corrected age. METHODS:We studied a multicenter cohort of 921 infants born before 28 weeks of gestation during 2002 to 2004 and assessed their placentas for histologic characteristics and microorganisms. The mother was interviewed and her medical record was reviewed. At 24 months adjusted age, children were assessed with BSID-II. Multinomial logistic models were used to estimate odds ratios. RESULTS:A total of 103 infants (11%) had an MDI ,55, and 99 infants (11%) had an MDI between 55 and 69. No associations were identified between organisms recovered from the placenta and developmental delay. Factors most strongly associated with MDI ,55 were thrombosis of fetal vessels (OR 3.1; 95% confidence interval [CI] 1.2, 7.7), maternal BMI .30 (OR 2.0; 95% CI 1.1, 3.5), maternal education #12 years (OR 3.4; 95% CI 1.9, 6.2), nonwhite race (OR 2.2; 95% CI 1.3, 3.8), birth weight z score , 22 (OR 2.8; 95% CI 1.1, 6.9), and male gender (OR 2.7; 95% CI 1.6, 4.5).CONCLUSIONS: Antenatal factors, including thrombosis of fetal vessels in the placenta, severe fetal growth restriction, and maternal obesity, convey information about the risk of cognitive impairment among extremely premature newborns. Pediatrics 2012;129:494-502

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Section: Discussionmentioning

confidence: 99%

Antenatal Antecedents of Cognitive Impairment at 24 Months In Extremely Low Gestational Age Newborns

et al. 2012

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“…Gestational diabetes mellitus, preeclampsia, induction of labour, increase rate of caesarean section, postpartum haemorrhage, anaemia, urinary tract infection, wound infection, prolonged pregnancy and preterm labour were significantly more common in pregnant women with higher BMI [6]. The infants born to obese women are at higher risk of having perinatal complications.…”

Section: Introductionmentioning

confidence: 94%

Impact of HIGH BMI on Pregnancy: Maternal and Foetal Outcome

Deshmukh

Jadhav

Yelikar

2016

J Obstet Gynecol India

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Aim and Objectives To review the effects of obesity (BMI [ 30) on antepartum risk/intrapartum risk. To study neonatal outcome of pregnant women with raised BMI. Material Method BMI of 500 pregnant women booked before 12 weeks calculated and categorised as normal, overweight, obese and morbidly obese at GMCH, Aurangabad. Pregnant women with systemic disease and previous LSCS were excluded. Antepartum, intrapartum and neonatal variables were studied, and statistical analysis was carried out.

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“…Our study design could not examine causality, but maternal obesity can result in premature birth, macrosomia, and congenital anomalies, which may explain the elevated odds of death across the spectrum from early neonatal to postneonatal deaths. 49 …”

Section: Risk Of Bias Across Studiesmentioning

confidence: 99%

Maternal Obesity and Infant Mortality: A Meta-Analysis

et al. 2014

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BACKGROUND AND OBJECTIVES: Despite numerous studies reporting an elevated risk of infant mortality among women who are obese, the magnitude of the association is unclear. A systematic review and metaanalysis was undertaken to assess the association between maternal overweight or obesity and infant mortality.METHODS: Four health care databases and gray literature sources were searched and screened against the protocol eligibility criteria. Observational studies reporting on the relationship between maternal overweight and obesity and infant mortality were included. Data extraction and risk of bias assessments were performed.RESULTS: Twenty-four records were included from 783 screened. Obese mothers (BMI $30) had greater odds of having an infant death (odds ratio 1.42; 95% confidence interval, 1.24-1.63; P , .001; 11 studies); these odds were greatest for the most obese (BMI .35) (odds ratio 2.03; 95% confidence interval, 1.61-2.56; P , .001; 3 studies). CONCLUSIONS:Our results suggest that the odds of having an infant death are greater for obese mothers and that this risk may increase with greater maternal BMI or weight; however, residual confounding may explain these findings. Given the rising prevalence of maternal obesity, additional high-quality epidemiologic studies to elucidate the actual influence of elevated maternal mass or weight on infant mortality are needed. If a causal link is determined and the biological basis explained, public health strategies to address the issue of maternal obesity will be needed. Mr Meehan developed the protocol, executed the search strategy, screened all records, assessed risk of bias, extracted data, carried out the data analysis, interpreted results, and prepared the manuscript draft; Dr Beck advised on study methods and analysis, extracted data, assessed methodological quality, and reviewed and revised the manuscript; Mr Mair-Jenkins extracted data, assessed methodological quality, and reviewed and revised the manuscript; Dr Leonardi-Bee advised on study methods and analysis, provided arbitration, critically appraised the analysis, and reviewed and revised the manuscript; Dr Puleston supervised the study, screened all records for eligibility, extracted data and prepared, and reviewed and revised the manuscript; and all authors approved the manuscript for submission.The protocol is registered at the National Institute for Health Research international prospective register of systematic reviews (identifier CRD42012002171). Overweight and obesity are increasing in women of childbearing age and during pregnancy. 2 The prevalence of maternal obesity ranges from 1.8% to 25.3% across different countries. 3 A recent study from the United States showed an increase in the prevalence of obesity during pregnancy from 13.0% in 1993 to 22.0% in 2003. 4 Obese pregnant women are likely to be older, have higher parity, and live in areas of higher deprivation than nonobese women. 3 Although global infant mortality rates have declined from 61 to 40 deaths per 1000 live births betw...

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Fetal and perinatal consequences of maternal obesity

Cited by 103 publications

References 46 publications

Antenatal Antecedents of Cognitive Impairment at 24 Months In Extremely Low Gestational Age Newborns

Antenatal Antecedents of Cognitive Impairment at 24 Months In Extremely Low Gestational Age Newborns

Impact of HIGH BMI on Pregnancy: Maternal and Foetal Outcome

Maternal Obesity and Infant Mortality: A Meta-Analysis

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