Document Detail


Maternal body mass index and the risk of fetal and infant death: a cohort study from the North of England.
MedLine Citation:
PMID:  21467206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Early pregnancy obesity (body mass index, BMI, ≥ 30 kg/m(2)) carries significant health implications. This cohort study investigates the association between early pregnancy BMI and the risk of fetal and infant death in pregnancies not affected by congenital anomalies or pre-gestational diabetes.
METHODS: Data on singleton pregnancies delivered during 2003-2005 at five hospitals were linked with data from three regional registers: the Northern Perinatal Mortality Survey, the Northern Diabetes in Pregnancy Survey and the Northern Congenital Abnormality Survey. Logistic regression models were used to determine the crude and adjusted odds ratios (aOR) of a spontaneous fetal death (≥ 20 weeks gestation) and infant death (aged up to 1 year), among underweight (BMI <18.5 kg/m(2)), overweight (BMI 25-29.9 kg/m(2)) and obese women compared with women of recommended BMI (18.5-24.9 kg/m(2)).
RESULTS: Obese women were at significantly increased risks of both fetal death [aOR = 2.32 (95% confidence interval: 1.64-3.28), P< 0.001] and infant death [aOR = 1.97 (1.13-3.45), P= 0.02]. Continuous analyses revealed a V-shaped relationship between BMI and the risk of fetal and infant death, with a minimum risk at 23 kg/m(2), and significantly increased risk thereafter for both fetal death [aOR, per unit = 1.07 (1.05-1.10), P< 0.001] and infant death [aOR, per unit = 1.06 (1.02-1.10), P= 0.007]. No significant excess risks, however, were identified for either maternal underweight [fetal death: aOR = 0.98 (0.42-2.25), P= 0.96; infant death: aOR = 1.89 (0.73-4.88), P= 0.19] or maternal overweight [fetal death: aOR = 1.34 (0.94-1.89), P= 0.10; infant death: aOR = 1.35 (0.79-2.32), P= 0.27] as categories. Except for higher rates of pre-eclampsia among stillbirths, no specific cause of death could explain the increased odds of fetal and infant death among the obese.
CONCLUSIONS: Early pregnancy obesity is significantly associated with fetal and infant death, independent of the known relationships with congenital anomalies and maternal pre-gestational diabetes.
Authors:
P W G Tennant; J Rankin; R Bell
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2011-04-05
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  26     ISSN:  1460-2350     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-18     Completed Date:  2011-09-12     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  1501-11     Citation Subset:  IM    
Affiliation:
Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK.
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Body Mass Index*
Cohort Studies
England / epidemiology
Female
Fetal Death / epidemiology,  etiology*
Humans
Infant
Infant Mortality*
Infant, Newborn
Obesity / complications*
Odds Ratio
Pregnancy
Pregnancy Complications*
Pregnancy Outcome
Risk
Stillbirth / epidemiology
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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