Maternal Prepregnancy BMI and Risk of Cerebral Palsy in Offspring

Abstract

OBJECTIVES: To investigate the association between maternal pre-pregnancy BMI and risk of cerebral palsy (CP) in offspring. METHODS:The study population consisted of 188 788 children in the Mothers and Babies in Norway and Denmark CP study, using data from 2 population-based, prospective birth cohorts: the Norwegian Mother and Child Cohort Study and the Danish National Birth Cohort. Prepregnancy BMI was classified as underweight (BMI <18.5), lower normal weight , upper normal weight ), overweight , and obese (BMI ≥30). CP diagnoses were obtained from the national CP registries. Associations between maternal prepregnancy BMI and CP in offspring were investigated by using logbinomial regression models. RESULTS:The 2 cohorts had 390 eligible cases of CP (2.1 per 1000 live-born children). Compared with mothers in the lower normal weight group, mothers in the upper normal group had a 40% excess risk of having a child with CP (relative risk [RR], 1.35; 95% confidence interval [CI], 1.03-1.78). Excess risk was 60% (RR, 1.56; 95% CI, 1.21-2.01) for overweight mothers and 60% (RR, 1.55; 95% CI 1.11-2.18) for obese mothers. The risk of CP increased ∼4% for each unit increase in BMI (RR, 1.04; 95% CI, 1.02-1.06). Estimates changed little with adjustment for mother's occupational status, age, and smoking habits. CONCLUSIONS:Higher prepregnancy maternal BMI was associated with increased risk of CP in offspring.a Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; b Department of Pediatrics, Haukeland University Hospital, Bergen, Norway; c Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina; d Ms Forthun was responsible for the analysis and interpretation of data, and the drafting of the manuscript; Dr Wilcox participated in the analysis and interpretation of data and reviewed and revised the manuscript; Drs Lie and Moster provided advice regarding study design, participated in the interpretation of data, and reviewed and revised the manuscript; Drs Strandberg-Larsen, Nohr, and Surén participated in the interpretation of data and reviewed and revised the manuscript; Dr Tollånes proposed the study, participated in the analysis and interpretation of data, and reviewed and revised the manuscript; and all authors approved the fi nal manuscript as submitted. The prevalence of overweight and obesity among pregnant women is increasing worldwide with adverse effects on maternal and child health. 6 Obese pregnant women (BMI >29.9) have increased risk of gestational diabetes, hypertension, and preeclampsia, and their offspring are at increased risk of preterm birth, macrosomia, complications during delivery, and perinatal death. 6 -9 Maternal obesity is also associated with birth defects, in particular neural tube defects. 10 We used pooled data from 2 large prospective Nordic birth cohorts to investigate the association between BMI before pregnancy and risk of CP in offspring, both overall and for variou...

Maternal obesity and risk of cerebral palsy in children: a systematic review and meta‐analysis

“…Except for maternal obesity, paternal obesity has also been found to be associated with increased risk of neurodevelopmental disabilities such as autism spectrum disorders and attention‐deficit/hyperactivity disorder in children . Among the included observational studies in our meta‐analysis on maternal obesity and CP, only one took paternal BMI into account . Unfortunately, it found no association between paternal obesity and risk of CP in children .…”

“…[18][19][20][21][22][23] An association between maternal obesity and the risk of CP in children has also been observed by several epidemiological studies. [24][25][26][27][28][29][30][31][32] However, the results were inconclusive. Some epidemiological studies reported that exposure to maternal obesity in utero was associated with an increased risk of CP, 24,25,[28][29][30][31] whereas others reported no statistically significant association.…”

“…[24][25][26][27][28][29][30][31][32] However, the results were inconclusive. Some epidemiological studies reported that exposure to maternal obesity in utero was associated with an increased risk of CP, 24,25,[28][29][30][31] whereas others reported no statistically significant association. 26,27,32 Therefore, we undertook a meta-analysis of published observational studies to address the question of whether maternal obesity was associated with increased risk of CP in children.…”

The risk, burden, and management of non‐communicable diseases in cerebral palsy: a scoping review

“…1 Diagnosis of CP is typically made between 12 and 24 months using a combination of standardized motor assessments, neuroimaging, and a medical history. [3][4][5] The causal pathway to CP is not well understood but risk factors include low birthweight, placental abnormalities, birth asphyxia, neonatal infections, emergency Caesarean delivery, 6 maternal obesity, [7][8][9] and low socio-economic status. [3][4][5] The causal pathway to CP is not well understood but risk factors include low birthweight, placental abnormalities, birth asphyxia, neonatal infections, emergency Caesarean delivery, 6 maternal obesity, [7][8][9] and low socio-economic status.…”

Delivering an action agenda for nutrition interventions addressing adolescent girls and young women: priorities for implementation and research

“…A focus on young girls is also crucial because their health and nutritional status before as well as during pregnancy also influences fetal growth and newborn health. Adolescent ill‐health and undernutrition is an important determinant of adverse fetal/neonatal outcomes, including small for gestational age (SGA) births, preterm births, stillbirths, and excess risk of neonatal mortality …”