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Pre-pregnancy weight and the risk of stillbirth and neonatal death.
BJOG. 2005 Apr; 112(4):403-8.BJOG

Abstract

OBJECTIVE

To evaluate the association between maternal pre-pregnancy body mass index (BMI) and the risk of stillbirth and neonatal death and to study the causes of death among the children.

DESIGN

Cohort study of pregnant women receiving routine antenatal care in Aarhus, Denmark.

SETTING

Aarhus University Hospital, Denmark, 1989-1996.

POPULATION

A total of 24,505 singleton pregnancies (112 stillbirths, 75 neonatal deaths) were included in the analyses.

METHODS

Information on maternal pre-pregnancy weight, height, lifestyle factors and obstetric risk factors were obtained from self-administered questionnaires and hospital files. We classified the population according to pre-pregnancy BMI as underweight (BMI <18.5 kg/m(2)), normal weight (BMI 18.5-24.9 kg/m(2)), overweight (BMI 25-29.9 kg/m(2)) and obese (BMI 30.0 kg/m(2) or more).

MAIN OUTCOME MEASURES

Stillbirth and neonatal death and causes of death.

RESULTS

Maternal obesity was associated with a more than doubled risk of stillbirth (odds ratio = 2.8, 95% confidence interval [CI]: 1.5-5.3) and neonatal death (odds ratio = 2.6, 95% CI: 1.2-5.8) compared with women of normal weight. No statistically significantly increased risk of stillbirth or neonatal death was found among underweight or overweight women. Adjustment for maternal cigarette smoking, alcohol and caffeine intake, maternal age, height, parity, gender of the child, years of schooling, working status and cohabitation with partner did not change the conclusions, nor did exclusion of women with hypertensive disorders or diabetes mellitus. No single cause of death explained the higher mortality in children of obese women, but more stillbirths were caused by unexplained intrauterine death and fetoplacental dysfunction among obese women compared with normal weight women.

CONCLUSION

Maternal obesity more than doubled the risk of stillbirth and neonatal death in our study. The present and other studies linking maternal obesity to an increased risk of severe adverse pregnancy outcomes emphasise the need for public interventions to prevent obesity in young women.

Authors+Show Affiliations

Perinatal Epidemiological Research Unit, Department of Obstetrics and Gynaecology, Aarhus University Hospital, 8200 Aarhus N, Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15777435

Citation

Kristensen, Janni, et al. "Pre-pregnancy Weight and the Risk of Stillbirth and Neonatal Death." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 112, no. 4, 2005, pp. 403-8.
Kristensen J, Vestergaard M, Wisborg K, et al. Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG. 2005;112(4):403-8.
Kristensen, J., Vestergaard, M., Wisborg, K., Kesmodel, U., & Secher, N. J. (2005). Pre-pregnancy weight and the risk of stillbirth and neonatal death. BJOG : an International Journal of Obstetrics and Gynaecology, 112(4), 403-8.
Kristensen J, et al. Pre-pregnancy Weight and the Risk of Stillbirth and Neonatal Death. BJOG. 2005;112(4):403-8. PubMed PMID: 15777435.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-pregnancy weight and the risk of stillbirth and neonatal death. AU - Kristensen,Janni, AU - Vestergaard,Mogens, AU - Wisborg,Kirsten, AU - Kesmodel,Ulrik, AU - Secher,Niels Jørgen, PY - 2005/3/22/pubmed PY - 2005/5/17/medline PY - 2005/3/22/entrez SP - 403 EP - 8 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 112 IS - 4 N2 - OBJECTIVE: To evaluate the association between maternal pre-pregnancy body mass index (BMI) and the risk of stillbirth and neonatal death and to study the causes of death among the children. DESIGN: Cohort study of pregnant women receiving routine antenatal care in Aarhus, Denmark. SETTING: Aarhus University Hospital, Denmark, 1989-1996. POPULATION: A total of 24,505 singleton pregnancies (112 stillbirths, 75 neonatal deaths) were included in the analyses. METHODS: Information on maternal pre-pregnancy weight, height, lifestyle factors and obstetric risk factors were obtained from self-administered questionnaires and hospital files. We classified the population according to pre-pregnancy BMI as underweight (BMI <18.5 kg/m(2)), normal weight (BMI 18.5-24.9 kg/m(2)), overweight (BMI 25-29.9 kg/m(2)) and obese (BMI 30.0 kg/m(2) or more). MAIN OUTCOME MEASURES: Stillbirth and neonatal death and causes of death. RESULTS: Maternal obesity was associated with a more than doubled risk of stillbirth (odds ratio = 2.8, 95% confidence interval [CI]: 1.5-5.3) and neonatal death (odds ratio = 2.6, 95% CI: 1.2-5.8) compared with women of normal weight. No statistically significantly increased risk of stillbirth or neonatal death was found among underweight or overweight women. Adjustment for maternal cigarette smoking, alcohol and caffeine intake, maternal age, height, parity, gender of the child, years of schooling, working status and cohabitation with partner did not change the conclusions, nor did exclusion of women with hypertensive disorders or diabetes mellitus. No single cause of death explained the higher mortality in children of obese women, but more stillbirths were caused by unexplained intrauterine death and fetoplacental dysfunction among obese women compared with normal weight women. CONCLUSION: Maternal obesity more than doubled the risk of stillbirth and neonatal death in our study. The present and other studies linking maternal obesity to an increased risk of severe adverse pregnancy outcomes emphasise the need for public interventions to prevent obesity in young women. SN - 1470-0328 UR - https://www.unboundmedicine.com/medline/citation/15777435/Pre_pregnancy_weight_and_the_risk_of_stillbirth_and_neonatal_death_ L2 - https://doi.org/10.1111/j.1471-0528.2005.00437.x DB - PRIME DP - Unbound Medicine ER -