Maternal pre-pregnancy BMI, MTHFR polymorphisms, and the risk of adverse pregnancy outcomes in pregnant women from South China: a retrospective cohort study

Abstract

Background Increasing evidence suggests an association between maternal pre-pregnancy body mass index (pre-BMI) and adverse pregnancy outcomes. However, the effects of methylenetetrahydrofolate reductase (MTHFR) polymorphisms on these relationships require further investigation. This study aimed to investigate whether the relationship between pre-BMI and the risk of adverse pregnancy outcomes was influenced by MTHFR gene polymorphisms. Methods A total of 5614 mother-fetus pairs were included in the study. The odds ratios (OR) of adverse pregnancy complications, including gestational diabetes mellitus (GDM), gestational hypertension (GHT), cesarean delivery (CS), and premature rupture of membranes (PROM), were estimated using adjusted logistic regression models and subgroup analysis. Results Pregnant women with higher pre-BMI values were positively related to the risk of GDM, GHT, and CS. In the subgroup analysis, underweight BMI was associated with a decreased risk of CS and GDM in pregnant women with the MTHFR A1298C AA or C677T CC genotype, while overweight/obese BMI was associated with an increased risk of GDM and CS in different MTHFR variants. Moreover, pregnant women with MTHFR A1298C AC + CC or C667T CC were found to have an increased risk of GHT in the MTHFR A1298C AA or C667T CT + TT genotype. A remarkable association was observed between the obesity group with MTHFR A1298C AC + CC (OR = 6.49, CI: 2.67–15.79) and the overweight group with the C667T CC genotype (OR = 4.72, CI: 2.13–10.45). Conclusions MTHFR gene polymorphisms exert a modifying effect on the association between maternal pre-BMI and the risk of GHT, CS, and GDM. Pregnant women with a high pre-BMI with specific MTHFR genotypes should be considered for GHT development.

Association between MTHFR gene C677T polymorphism and gestational diabetes mellitus in Chinese population: a meta-analysis

“…( 37 ) and Wang et al. ( 35 ) showed an impact on the overall results in the allele model ( Supplementary Figure 1A ), and several studies ( 14 , 28 – 30 , 32 , 37 , 39 , 40 31 , 35 , 38 ) showed an impact on the overall results in the heterozygote model ( Supplementary Figure 1C ). Thus, more high-quality studies are still needed to further confirm our findings.…”

“…Initially, 112 records were identified from the six databases. Ultimately, a total of 18 available studies were included in this meta-analysis after reviewing the titles, abstracts and full texts (14,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41).…”

Development and Validation of a Multivariable Predictive Model for the Risk of Histologic Chorioamnionitis in Patients with Premature Rupture of Membranes in the Late Preterm and Term

“…Insufficient maternal intake can lead to malnutrition, and lower weight gain is associated with an increased risk of adverse maternal and infant outcomes. 35,36 Rudra et al 37 have identified a lower BMI in pregnant women as a risk factor for PROM and an increased risk of HCA. Consistent with these findings, our study also showed a lower BMI in the HCA group, and it acted as a protective factor in the combined model, indicating that appropriate weight gain before delivery was associated with a lower incidence of HCA.…”

Interaction effects of MTHFR C677T and A1298C polymorphisms with maternal glycated haemoglobin levels on adverse birth outcomes

“…14 Similarly, our previous studies had indicated that pregnant women who were obese, with the CT þ TT genotype, were 2.40 times more likely to have GDM, whereas no significant association was observed in those with the CC genotype. 31 In addition, an…”