Impact of maternal body mass index and gestational weight gain on pregnancy complications: An individual participant data meta-analysis of European, North American and Australian cohorts

Susana Santos, Ellis Voerman, Pilar Amiano, Henrique Barros, Lawrence J Beilin, Anna Bergström, Marie-Aline Charles, Leda Chatzi, Cécile Chevrier, George P Chrousos, Eva Corpeleijn, Olga Costa, Nathalie Costet, Sarah Crozier, Graham Devereux, Myriam Doyon, Merete Eggesbø, Maria Pia Fantini, Sara Farchi, Francesco ForastiereVagelis Georgiu, Keith M Godfrey, Davide Gori, Veit Grote, Wojciech Hanke, Irva Hertz-Picciotto, Barbara Heude, Marie-France Hivert, Daniel Hryhorczuk, Rae-Chi Huang, Hazel Inskip, Anne M Karvonen, Louise C Kenny, Berthold Koletzko, Leanne K Küpers, Hanna Lagström, Irina Lehmann, Per Magnus, Renata Majewska, Johanna Mäkelä, Yannis Manios, Fionnuala M McAuliffe, Sheila W McDonald, John Mehegan, Erik Melén, Monique Mommers, Camilla S Morgen, George Moschonis, Deirdre Murray, Carol Ní Chaoimh, Ellen A Nohr, Anne-Marie Nybo Andersen, Emily Oken, Adriëtte J J M Oostvogels, Agnieszka Pac, Eleni Papadopoulou, Juha Pekkanen, Costanza Pizzi, Kinga Polanska, Daniela Porta, Lorenzo Richiardi, Sheryl L Rifas-Shiman, Nel Roeleveld, Luca Ronfani, Ana C Santos, Marie Standl, Hein Stigum, Camilla Stoltenberg, Elisabeth Thiering, Carel Thijs, Maties Torrent, Suzanne C Tough, Tomas Trnovec, Steve Turner, Marleen M H J van Gelder, Lenie van Rossem, Andrea von Berg, Martine Vrijheid, Tanja G M Vrijkotte, Jane West, Alet H Wijga, John Wright, Oleksandr Zvinchuk, Thorkild I A Sørensen, Debbie A Lawlor, Romy Gaillard, Vincent W V Jaddoe

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

OBJECTIVE: To assess the separate and combined associations of maternal pre-pregnancy BMI and gestational weight gain with the risks of pregnancy complications and their population impact.

DESIGN: Individual participant data meta-analysis of 39 cohorts.

SETTING: Europe, North America and Oceania.

POPULATION: 265,270 births.

METHODS: Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used.

MAIN OUTCOME MEASURES: Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large size for gestational age at birth.

RESULTS: Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes and large size for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared to normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (Odds Ratio 2.51 (95% Confidence Interval 2.31, 2.74)). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large size for gestational age infants was attributable to excessive gestational weight gain.

CONCLUSIONS: Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with the risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)984-995
Number of pages12
JournalBJOG : An International Journal of Obstetrics and Gynaecology
Volume126
Issue number8
DOIs
Publication statusPublished - Jul-2019

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