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Mortality in infants of obese mothers: Is risk modified by mode of delivery?
MedLine Citation:
PMID:  22122755     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To examine the association between maternal obesity and infant mortality while including information about mode of delivery and interpregnancy weight change. Design. Register-based cohort study. Setting and population: 1 199 183 singletons including 3 481 infant deaths from the Swedish Birth Register 1992-2006. Methods. Maternal body mass index (BMI) was obtained from self-reports in early pregnancy and categorized as underweight (<18.5), normal-weight (18.5-24.9), overweight (25-29.9), obese (BMI 30-34.9), and extremely obese (BMI 35+). Cox regression was used to estimate hazard ratios (HR (95% confidence intervals). Infants of normal-weight women were the referent. Main outcome measure. Neonatal and infant mortality. Results. Infant mortality increased with increasing maternal fatness (adjusted HRs 1.2 (1.1-1.3), 1.4 (1.2-1.6), and 2.1 (1.8-2.5) for overweight, obesity and extreme obesity). When accounting for mode of delivery, neonatal mortality was increased in infants of obese and extremely obese mothers after spontaneous births (adjusted HRs 1.8 (1.4-2.4) and 2.6 (1.8-4.0) after term births, and 1.4 (1.1-1.9), and 2.2 (1.5-3.3) after preterm births). No excess risk was present for infants of obese mothers after induced term and preterm births (p-values for interaction <0.05). For post-neonatal mortality, no interaction between mode of delivery and maternal obesity was observed. In women with two subsequent pregnancies, high interpregnancy weight change >1 BMI-unit seemed to involve a modest increase in neonatal mortality in the second infant, but only after spontaneous births (adjusted HR 1.3 (0.9-1.7)). Conclusion. Maternal obesity, especially at levels that may involve cardio-metabolic morbidity, was associated with increased mortality in the offspring.
Authors:
Ellen A Nohr; Eduardo Villamor; Michael Vaeth; Jorn Olsen; Sven Cnattingius
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-29
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors AOGS© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of Epidemiology, Institute of Public Health, Aarhus University, Aarhus, Denmark, Departments of Environmental Health Sciences and Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan,USA, Department of Biostatistics, Institute of Public Health, Aarhus University, Aarhus, Denmark, and Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
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