Pre-pregnancy underweight and obesity are positively associated with small-for-gestational-age infants in a Chinese population

Chen, Yuan Hua; Li, Li; Chen, Wei; Liu, Zhi Bing; Ma, Li; Gao, Xing; He, Jia Liu; Wang, Hua; Zhao, Mingqiu; Yang, Yuan; Xu, De Xiang

doi:10.1038/s41598-019-52018-7

Cited by 30 publications

(32 citation statements)

References 47 publications

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“…This corresponds to a recent study from Finland showing that 63.8% of women born in Somalia were overweight/obese compared to 29.7% of Finnish women [30]. One study found an association between obesity (but not overweight) and higher risk for giving birth to a baby small for gestational age (RR 2.66, CI 2.01, 3.52) [31] but other studies have shown inconsistent results of the link between overweight and SGA [32]. Another possible explanation is that placenta-mediated diseases (like preeclampsia and SGA) and epigenetic factors can be transferred to the following generations [33].…”

Section: Discussionsupporting

confidence: 80%

Pregnancy outcomes among women born in Somalia and Sweden giving birth in the Stockholm area – a population-based study

Akselsson

Lindgren

Georgsson

et al. 2020

Global Health Action

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Background: Studies report that women born in some African countries, after migrating to the Nordic countries, have worse pregnancy outcomes than women born in the receiving countries. With the aim of identifying unmet needs among Somali-born women, we here study this subgroup. Objective: We compared pregnancy outcomes among women born in Somalia to women born in Sweden. Further, we investigated whether the proactive maternal observation of fetal movements has effects on birth outcomes among women born in Somalia. Methods: In Stockholm, half of the maternity clinics were randomized to intervention, in which midwives were instructed to be proactive towards women by promoting daily selfmonitoring of fetal movements. Data for 623 women born in Somalia and 26 485 born in Sweden were collected from a population-based register. Results: An Apgar score below 7 (with stillbirth counting as 0) at 5 minutes was more frequent in babies of women born in Somalia as compared to babies of women born in Sweden (RR 2.17, 95% CI 1.25-3.77). Babies born small for gestational age were more common among women born in Somalia (RR 2.22, CI 1.88-2.61), as were babies born after 41 + 6 gestational weeks (RR 1.65, CI 1.29-2.12). Somali-born women less often contacted obstetric care for decreased fetal movements than did Swedish-born women (RR 0.19, CI 0.08-0.36). The differences between women born in Somalia and women born in Sweden were somewhat lower (not statistically significant) among women allocated to proactivity as compared to the Routine-care group. Conclusions: A higher risk of a negative outcome for mother and baby is seen among women born in Somalia compared to women born in Sweden. We suggest it may be worthwhile to investigate whether a Somali-adapted intervention with proactivity concerning self-monitoring of fetal movements may improve pregnancy outcomes in this migrant population.

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Section: Discussionsupporting

confidence: 80%

Pregnancy outcomes among women born in Somalia and Sweden giving birth in the Stockholm area – a population-based study

Akselsson

Lindgren

Georgsson

et al. 2020

Global Health Action

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“…Maternal demographic characteristics, such as maternal age, pre-pregnancy BMI, parity and maternal education, were associated with birth weight and the risk of SGA infants. A number of epidemiological studies demonstrated that advanced maternal age, primiparity and low BMI before pregnancy elevated the risks of SGA and low birth weight infants [21][22][23] . Several reports indicated that the risk of SGA was higher in low educational subjects compared with high educational subjects 24,25 .…”

Section: Discussionmentioning

confidence: 99%

Continuous association of total bile acid levels with the risk of small for gestational age infants

Chen

et al. 2020

Sci Rep

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The association between maternal serum total bile acid (TBA) levels and small-for-gestational-age (SGA) infants is unclear. We investigated the association between various degrees of serum TBA levels and the risk of SGA infants in a Chinese population. The current study performed a cohort study among 11811 mothers with singleton pregnancy. Subjects were divided into seven categories according to maternal serum TBA levels. Interestingly, birth sizes were reduced, whereas the rate of SGA infants was increased across increasing categories of serum TBA. Compared to category 1, adjusted ORs (95%CI) for SGA infants were 0.99 (0.82-1.21) in category 2, 1.22 (0.97-1.53) in category 3, 1.99 (1.53-2.58) in category 4, 2.91 (2.16-3.93) in category 5, 4.29 (3.33-5.54) in category 6, and 9.01 (5.99-13.53) in category 7, respectively. Furthermore, adjusted ORs (95%CI) for SGA infants for each 1-SD increase in serum TBA levels were 1.36 (1.29-1.43) among all subjects, 2.40 (1.82-3.45) among subjects without cholestasis, and 1.13 (1.06-1.22) among subjects with cholestasis, respectively. These results suggest that gestational cholestasis increases the risk of SGA infants. Additionally, our results indicate strong, continuous associations of serum TBA levels below those diagnostic of cholestasis with a decreased birth sizes and an increased risk of SGA infants.

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“…The birth cohort included 13,801 pregnant women who received antenatal care and delivery in the first affiliated Hospital of Anhui Medical University from January 2011 to December 2014 43 . The diagnosis of ICP was based on the presence of pruritus in combination with elevated serum levels of total bile acid (TBA ≥ 10 μmol/L).…”

Section: Participantsmentioning

confidence: 99%

Prevalence and risk factors of intrahepatic cholestasis of pregnancy in a Chinese population

Gao

Liu

et al. 2020

Sci Rep

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Studies on the risk factors for intrahepatic cholestasis of pregnancy (ICP) in a population-based cohort are lacking. We assess the prevalence and risk factors of ICP in a Chinese population. In this study, a cohort study was conducted that included 12,200 eligible pregnant women. The overall incidence of ICP in this cohort was 6.06%. With increasing maternal age, the incidence of ICP decreased in women younger than 30 years of age but increased in those older than 30. With increasing pre-pregnancy BMI, the incidence of ICP decreased if the pre-pregnancy BMI was less than 23 kg/m2 but increased if it was 23 kg/m2 or higher. Further analysis showed that the risk of ICP increased when maternal age was < 25 years (Adjusted RR 2.01; 95% CI 1.64–2.47) or ≥ 35 years (Adjusted RR 1.34; 95% CI 1.02–1.76). Furthermore, an increased risk of ICP was associated with pre-pregnancy underweight (adjusted RR 1.27; 95% CI 1.04–1.56), inadequate gestational weight gain (GWG) (adjusted RR 1.58; 95% CI 1.28–1.96), lower maternal education (adjusted RR 2.96; 95% CI 2.35–3.74), multiparity (adjusted RR 1.54; 95% CI 1.23–1.93), and twin/multiple pregnancies (adjusted RR 2.12; 95% CI 1.25–3.58). Maternal age (< 25 or ≥ 35 years), underweight, inadequate GWG, lower maternal education, multiparity, and twin/multiple pregnancies were identified as risk factors of ICP.

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Pre-pregnancy underweight and obesity are positively associated with small-for-gestational-age infants in a Chinese population

Cited by 30 publications

References 47 publications

Pregnancy outcomes among women born in Somalia and Sweden giving birth in the Stockholm area – a population-based study

Pregnancy outcomes among women born in Somalia and Sweden giving birth in the Stockholm area – a population-based study

Continuous association of total bile acid levels with the risk of small for gestational age infants

Prevalence and risk factors of intrahepatic cholestasis of pregnancy in a Chinese population

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