In-hospital mortality and morbidity among extremely preterm infants in relation to maternal body mass index

Chawla, Sanjay; Laptook, Abbot R.; Smith, Emily Ann; Tan, Sylvia; Natarajan, Girija; Wyckoff, Myra H.; Ambalavanan, Namasivayam; Bell, Edward F.; Meurs, Krisa P. Van; Stevenson, David K.; Werner, Erika F.; Greenberg, Rachel G.; Das, Abhik; Shankaran, Seetha

doi:10.1038/s41372-020-00847-0

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…In this study, Preterm neonates whose mothers' pre-pregnancy BMI was greater than and equal to twenty-five kg/m2 were at a higher risk of death than those whose mothers’ BMI was less than 18.5 kg/m2. This is in line with another study that revealed that a rise in maternal pre-pregnancy BMI was associated with diminished odds of infant survival [ 31 ].…”

Section: Discussionsupporting

confidence: 92%

“…The sample size was calculated using Open Epi Info 7 stat calc double population proportion formula with the assumptions of 95% CI, 80% power, and one to two exposed to unexposed ratio, by using gestational age as the exposure variable, the proportion of death among neonates delivered at a gestational age of 33 weeks is 22.6% and proportion of death among neonates delivered at a gestational age of 34 weeks is 9.6% in Addis Ababa teaching hospitals [ 31 ]. The final sample size with a 10% loss follow-up was 462 preterm neonates.…”

Section: Methodsmentioning

confidence: 99%

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Neonatal outcomes of preterm neonates and its predictors in Ethiopian public hospitals: Multicenter prospective follow-up study

Hailemeskel,

Dagnaw,

Demis

et al. 2023

Heliyon

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Section: Discussionsupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Neonatal outcomes of preterm neonates and its predictors in Ethiopian public hospitals: Multicenter prospective follow-up study

Hailemeskel,

Dagnaw,

Demis

et al. 2023

Heliyon

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“…Since SGA and race have been shown to be associated with the development of NEC, we further corrected for this in our model but still found significance. In a recently published multi-center cohort study [ 19 ] of 22 to 28-week infants born in 2016–2018, Chawla et al showed that pre-pregnancy obesity was associated with decreased adjusted odds of infant survival and decreased odds of survival without NEC in comparison with overweight or normal BMI. Lack of association in models that included GA and SGA suggests that the effect of increased BMI on survival and survival without NEC was in part mediated by GA and size for GA.…”

Section: Discussionmentioning

confidence: 99%

Maternal body mass index and necrotizing enterocolitis: A case-control study

Stumpf,

Sharma,

Brown

et al. 2024

PLoS ONE

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Introduction Our aim was to determine if maternal body mass index (BMI) is associated with necrotizing enterocolitis (NEC) in a large urban delivery center. Methods This single center retrospective case-control study included 291 infants under gestational age of 33 weeks admitted to the neonatal intensive care unit (NICU) during a 10-year period. Cases of stage 2 and 3 NEC were matched at a ratio of 2 controls (n = 194) to 1 case (n = 97). Maternal BMI was categorized as normal (≤24.9), overweight (25–29.9) and obese (≥30). Chi-square and stepwise logistic regression were used for analysis. A power analysis was performed to determine if sample size was sufficient to detect an association. Results Stepwise logistic regression demonstrated no association between NEC and maternal obesity. Maternal hypertension, pre-eclampsia, premature rupture of membranes, maternal exposure to antibiotics, placental abruption and gestational diabetes were not associated with NEC. Power analysis showed the sample size was sufficient to detect an association of NEC with maternal BMI in three groups analyzed. In this case-control study, there was an association between NEC and maternal overweight but not obesity at delivery. Discussion Our results did not show a significant association of NEC with maternal obesity. The percent of overweight and obese mothers prior to pregnancy and at delivery was significantly higher in our population than the national average and may be responsible for the limited ability to reveal any association between maternal obesity and NEC.

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“…We previously reported the in-hospital survival and major morbidities in extremely preterm infants in relation to maternal body mass index (BMI). 10 Maternal BMI data were available for 2415 infants. Survival without any major morbidity was not different between groups: 30.8% in the underweight/normal, 28.1% in the overweight, and 28.5% in the obese (P = .65).…”

Section: Introductionmentioning

confidence: 99%

Association of Maternal Pre-Pregnancy or First Trimester Body Mass Index with Neurodevelopmental Outcome in Extremely Low Gestational Age Neonates

Chawla,

Laptook,

Smith

et al. 2023

Preprint

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Objective: To compare the rates of death or survival with severe neurodevelopmental impairment (sNDI) at 2 years among extremely preterm infants in relation to pre-pregnancy or first trimester maternal body mass index (BMI). Methods: This retrospective cohort study included extremely preterm infants (gestational age 220/7-266/7 weeks). The study was conducted at National Institute of Child Health and Human Development Neonatal Research Network sites. The primary outcome was death or sNDI at 2 years. Results: Data on the primary outcome were available for 1,208 children. Death or sNDI was not different among the three groups: 54.9% in normal, 56.1% in overweight, and 53.4% in obese group (p=0.39). There was no significant difference in mortality, sNDI, moderate/severe cerebral palsy, Bayley Scales of Infant Development (BSID)-III cognitive composite score <70, BSID-III language composite score <70 in adjusted models. Conclusion: Neurodevelopmental outcome was not significantly associated with maternal pre-pregnancy BMI among extreme preterm infants.

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In-hospital mortality and morbidity among extremely preterm infants in relation to maternal body mass index

Cited by 6 publications

References 28 publications

Neonatal outcomes of preterm neonates and its predictors in Ethiopian public hospitals: Multicenter prospective follow-up study

Neonatal outcomes of preterm neonates and its predictors in Ethiopian public hospitals: Multicenter prospective follow-up study

Maternal body mass index and necrotizing enterocolitis: A case-control study

Association of Maternal Pre-Pregnancy or First Trimester Body Mass Index with Neurodevelopmental Outcome in Extremely Low Gestational Age Neonates

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