The Impact of Exposure Misclassification on Associations Between Prepregnancy BMI and Adverse Pregnancy Outcomes

Bodnar, Lisa M.; Siega‐Riz, Anna Maria; Simhan, Hyagriv N.; Diesel, Jill; Abrams, Barbara

doi:10.1038/oby.2010.25

“…41,42 However, it is unlikely that height and weight reporting differed according to child outcome measures or that reporting of developmental diagnoses differed according to prepregnancy BMI. Thus, the impact of using self-reported measures for weight and height would probably be a bias toward the null hypothesis; the associations reported here might therefore be conservative.…”

Section: Discussionmentioning

confidence: 99%

Maternal Prepregnancy Body Mass Index and Child Psychosocial Development at 6 Years of Age

Jo

¹

,

Schieve

²

,

Sharma

³

et al. 2015

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BACKGROUND: Both obesity and developmental disabilities have increased in recent decades. Limited studies suggest associations between maternal prepregnancy obesity and child neurodevelopment. METHODS:The Infant Feeding Practices Study II, a US nationally distributed longitudinal study of maternal health and infant health and feeding practices, was conducted from 2005 to 2007. In 2012, mothers were recontacted for information on their children's health and development. We examined associations between maternal prepregnancy BMI and child psychosocial development in 1311 mother-child pairs included in this follow-up study. Children's development was assessed by maternal report of child psychosocial difficulties from the Strengths and Difficulties Questionnaire, past developmental diagnoses, and receipt of special needs services.RESULTS: Adjusting for sociodemographic factors, children of obese class II/III mothers (BMI .35.0) had increased odds of emotional symptoms (adjusted odds ratio [aOR] 2.24; 95% confidence interval [CI], 1.27-3.98), peer problems (aOR 2.07; 95% CI, 1.26-3.40), total psychosocial difficulties (aOR 2.17; 95% CI, 1.24-3.77), attention-deficit/hyperactivity disorder diagnosis (aOR 4.55; 95% CI, 1.80-11.46), autism or developmental delay diagnosis (aOR 3.13; 95% CI, 1.10-8.94), receipt of speech language therapy (aOR 1.93; 95% CI, 1.18-3.15), receipt of psychological services (aOR 2.27; 95% CI, 1.09-4.73), and receipt of any special needs service (aOR 1.99; 95% CI, 1.33-2.97) compared with children of normal weight mothers ). Adjustment for potential causal pathway factors including pregnancy weight gain, gestational diabetes, breastfeeding duration, postpartum depression, and child's birth weight did not substantially affect most estimates.CONCLUSIONS: Children whose mothers were severely obese before pregnancy had increased risk for adverse developmental outcomes.WHAT'S KNOWN ON THIS SUBJECT: Both obesity and developmental disabilities have increased in recent decades; however, the full long-term effects of prepregnancy obesity on a child' s psychosocial development remain unknown. Limited studies suggest associations between maternal prepregnancy obesity and child psychosocial development. WHAT THIS STUDY ADDS:This study in 6-year-old children provides evidence that severe prepregnancy obesity is associated with adverse child psychosocial outcomes, including attentiondeficit/hyperactivity disorder. These findings were not explained by many pregnancy and postpartum factors related to maternal obesity or child development.

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“…41,42 However, it is unlikely that height and weight reporting differed according to child outcome measures or that reporting of developmental diagnoses differed according to prepregnancy BMI. Thus, the impact of using self-reported measures for weight and height would probably be a bias toward the null hypothesis; the associations reported here might therefore be conservative.…”

Section: Discussionmentioning

confidence: 99%

Maternal Prepregnancy Body Mass Index and Child Psychosocial Development at 6 Years of Age

2015

PEDIATRICS

0

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BACKGROUND: Both obesity and developmental disabilities have increased in recent decades. Limited studies suggest associations between maternal prepregnancy obesity and child neurodevelopment. METHODS:The Infant Feeding Practices Study II, a US nationally distributed longitudinal study of maternal health and infant health and feeding practices, was conducted from 2005 to 2007. In 2012, mothers were recontacted for information on their children's health and development. We examined associations between maternal prepregnancy BMI and child psychosocial development in 1311 mother-child pairs included in this follow-up study. Children's development was assessed by maternal report of child psychosocial difficulties from the Strengths and Difficulties Questionnaire, past developmental diagnoses, and receipt of special needs services.RESULTS: Adjusting for sociodemographic factors, children of obese class II/III mothers (BMI .35.0) had increased odds of emotional symptoms (adjusted odds ratio [aOR] 2.24; 95% confidence interval [CI], 1.27-3.98), peer problems (aOR 2.07; 95% CI, 1.26-3.40), total psychosocial difficulties (aOR 2.17; 95% CI, 1.24-3.77), attention-deficit/hyperactivity disorder diagnosis (aOR 4.55; 95% CI, 1.80-11.46), autism or developmental delay diagnosis (aOR 3.13; 95% CI, 1.10-8.94), receipt of speech language therapy (aOR 1.93; 95% CI, 1.18-3.15), receipt of psychological services (aOR 2.27; 95% CI, 1.09-4.73), and receipt of any special needs service (aOR 1.99; 95% CI, 1.33-2.97) compared with children of normal weight mothers ). Adjustment for potential causal pathway factors including pregnancy weight gain, gestational diabetes, breastfeeding duration, postpartum depression, and child's birth weight did not substantially affect most estimates.CONCLUSIONS: Children whose mothers were severely obese before pregnancy had increased risk for adverse developmental outcomes.WHAT'S KNOWN ON THIS SUBJECT: Both obesity and developmental disabilities have increased in recent decades; however, the full long-term effects of prepregnancy obesity on a child' s psychosocial development remain unknown. Limited studies suggest associations between maternal prepregnancy obesity and child psychosocial development. WHAT THIS STUDY ADDS:This study in 6-year-old children provides evidence that severe prepregnancy obesity is associated with adverse child psychosocial outcomes, including attentiondeficit/hyperactivity disorder. These findings were not explained by many pregnancy and postpartum factors related to maternal obesity or child development.

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“…Dans une autre étude de l'impact du biais dans l'IMC prégestationnel sur cinq issues de grossesse (dont le FPAG et le PEAG) 20 , les associations n'ont pas été modifiées de façon significative mais ont été quelque peu atté-nuées par les erreurs de déclaration. Les études sur le biais dans l'IMC en lien avec d'autres résultats en matière de santé, tels que les maladies chroniques liées au poids (p. ex.…”

Section: Tableau 3 Répartition De L'indice De Masse Corporelle (Imc) unclassified

Estimation du biais lié à l’indice de masse corporelle utilisé dans l’Enquête canadienne sur l’expérience de la maternité

Dzakpasu

¹

,

Duggan²,

Fahey³

et al. 2016

Promotion De La Santé Et Prévention Des Maladies Chroniques Au Canada

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Introduction Cette étude visait à évaluer le biais dans la mesure de l’indice de masse corporelle (IMC) dans l’Enquête canadienne sur l’expérience de la maternité (ECEM) ainsi que les répercussions possibles de ce biais sur l’association entre l’IMC et certaines issues de grossesse. Méthodologie Nous avons évalué la répartition des valeurs de l’IMC en comparant des données autodéclarées et des données mesurées. Nous avons utilisé un échantillon aléatoire de 6 175 participantes à l’ECEM dont l’IMC avait été calculé d’après la taille et le poids autodéclarés et un échantillon aléatoire de 259 participantes à l’Enquête canadienne sur les mesures de santé (ECMS) ayant déjà accouché et dont l’IMC avait été calculé d’après la taille et le poids autodéclarés et mesurés. Nous avons appliqué deux équations de correction à l’IMC fondé sur des valeurs autodéclarées, et nous avons examiné l’impact de ces corrections sur les associations entre l’IMC et un accouchement par césarienne, un faible poids pour l’âge gestationnel (FPAG) et un poids élevé pour l’âge gestationnel (PEAG). Résultats Dans l’ensemble, 86,9 % des femmes du sous-échantillon de l’ECMS appartenaient à la même catégorie d’IMC lorsque ses valeurs étaient autodéclarées et lorsqu’elles étaient mesurées. Cependant, les différences de répartition ont eu un effet considérable sur la proportion de femmes des catégories de poids insuffisant et d’obésité. Par exemple, le pourcentage de femmes classées comme obèses était de 14,5 % avec les données autodéclarées contre 20,8 % avec les données mesurées. Les corrections ont permis d’améliorer les estimations de la prévalence de l’obésité, mais ont surestimé ou sous-estimé les autres catégories d’IMC. Les corrections ont eu un effet non significatif sur les associations entre l’IMC et l’accouchement par césarienne, le FPAG et le PEAG. Conclusion Bien que la concordance pour la répartition des valeurs de l’IMC entre la taille et le poids autodéclarés et la taille et le poids mesurés soit élevée, il existe un biais dans les mesures fondées sur les valeurs autodéclarées susceptible d’entraîner de légères surestimations ou sous-estimations des risques associés à une catégorie d’IMC donnée. La tendance générale des associations reste néanmoins inchangée.

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The Impact of Exposure Misclassification on Associations Between Prepregnancy BMI and Adverse Pregnancy Outcomes

Cited by 81 publications

References 30 publications

Maternal Prepregnancy Body Mass Index and Child Psychosocial Development at 6 Years of Age

Maternal Prepregnancy Body Mass Index and Child Psychosocial Development at 6 Years of Age

Maternal Prepregnancy Body Mass Index and Child Psychosocial Development at 6 Years of Age

Estimation du biais lié à l’indice de masse corporelle utilisé dans l’Enquête canadienne sur l’expérience de la maternité

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