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Sociodemographic factors and pregnancy outcomes associated with prepregnancy obesity: effect modification of parity in the nationwide Epifane birth-cohort.
BMC Pregnancy Childbirth 2017; 17(1):273BP

Abstract

BACKGROUND

In light of the adverse outcomes for mothers and offspring related to maternal obesity, identification of subgroups of women at risk of prepregnancy obesity and its related-adverse issues is crucial for optimizing antenatal care. We aimed to identify sociodemographic factors and maternal and neonatal outcomes associated with prepregnancy obesity, and we tested the effect modification of parity on these associations.

METHODS

In 2012, 3368 mothers who had delivered in 136 randomly selected maternity wards were included just after birth in the French birth cohort, Epifane. Maternal height and weight before and at the last month of pregnancy were self-reported. Maternal and neonatal outcomes were collected in medical records. Prepregnancy Body Mass Index (pBMI) was classified into underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9) and obesity (≥30.0). Since we found statistically significant interactions with parity, the multinomial logistic regression model estimating associations of pBMI class with sociodemographic characteristics and pregnancy outcomes was stratified on parity (1335 primiparous and 1814 multiparous).

RESULTS

Before pregnancy, 7.6% of women were underweight, 64.2% were of normal weight, 18.0% were overweight and 10.2% were obese. Among the primiparous, maternal age of 25-29 years (OR = 2.09 [1.13-3.87]; vs. 30-34 years), high school level (OR = 2.22 [1.33-3.73]; vs. university level), gestational diabetes (OR = 2.80 [1.56-5.01]) and hypertensive complications (OR = 3.80 [1.83-7.89]) were independently associated with prepregnancy obesity. Among the multiparous, primary (OR = 6.30 [2.40-16.57]), junior high (OR = 2.89 [1.81-4.64]) and high school (OR = 1.86 [1.18-2.93]) education levels (vs. university level), no attendance at antenatal classes (OR = 1.77 [1.16-2.72]), excess gestational weight gain (OR = 1.82 [1.20-2.76]), gestational diabetes (OR =5.16 [3.15-8.46]), hypertensive complications (OR = 8.13 [3.97-16.64]), caesarean delivery (OR = 1.80 [1.18-2.77]) and infant birth weight ≥ 4 kg (OR = 1.70 [1.03-2.80]; vs. birth weight between 2.5 kg and 4 kg) were independently associated with prepregnancy obesity.

CONCLUSION

Obesity before pregnancy is associated with a set of sociodemographic characteristics and adverse pregnancy outcomes that differ across parity groups. Such findings are useful for targeted health policies aimed at attaining healthy prepregnancy weight and organizing perinatal care.

Authors+Show Affiliations

Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Paris-13 University, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, SMBH Building, 1st floor, door 136, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France. julie.boudet-berquier@univ-paris13.fr.Nutritional Surveillance and Epidemiology Team (ESEN), French Public Health Agency, Paris-13 University, Centre de Recherche en Epidémiologie et Statistiques, COMUE Sorbonne Paris Cité, SMBH Building, 1st floor, door 136, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France.French Public Health Agency (Agence nationale de Santé publique), Saint Maurice, France.Centre de Recherche « Epidémiologie, Biostatistique et Recherche clinique », School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28841845

Citation

Boudet-Berquier, Julie, et al. "Sociodemographic Factors and Pregnancy Outcomes Associated With Prepregnancy Obesity: Effect Modification of Parity in the Nationwide Epifane Birth-cohort." BMC Pregnancy and Childbirth, vol. 17, no. 1, 2017, p. 273.
Boudet-Berquier J, Salanave B, Desenclos JC, et al. Sociodemographic factors and pregnancy outcomes associated with prepregnancy obesity: effect modification of parity in the nationwide Epifane birth-cohort. BMC Pregnancy Childbirth. 2017;17(1):273.
Boudet-Berquier, J., Salanave, B., Desenclos, J. C., & Castetbon, K. (2017). Sociodemographic factors and pregnancy outcomes associated with prepregnancy obesity: effect modification of parity in the nationwide Epifane birth-cohort. BMC Pregnancy and Childbirth, 17(1), p. 273. doi:10.1186/s12884-017-1456-8.
Boudet-Berquier J, et al. Sociodemographic Factors and Pregnancy Outcomes Associated With Prepregnancy Obesity: Effect Modification of Parity in the Nationwide Epifane Birth-cohort. BMC Pregnancy Childbirth. 2017 Aug 25;17(1):273. PubMed PMID: 28841845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sociodemographic factors and pregnancy outcomes associated with prepregnancy obesity: effect modification of parity in the nationwide Epifane birth-cohort. AU - Boudet-Berquier,Julie, AU - Salanave,Benoit, AU - Desenclos,Jean-Claude, AU - Castetbon,Katia, Y1 - 2017/08/25/ PY - 2016/11/28/received PY - 2017/08/17/accepted PY - 2017/8/27/entrez PY - 2017/8/27/pubmed PY - 2018/5/17/medline KW - Adverse pregnancy outcomes KW - Maternal obesity KW - National birth cohort KW - Social inequalities SP - 273 EP - 273 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 17 IS - 1 N2 - BACKGROUND: In light of the adverse outcomes for mothers and offspring related to maternal obesity, identification of subgroups of women at risk of prepregnancy obesity and its related-adverse issues is crucial for optimizing antenatal care. We aimed to identify sociodemographic factors and maternal and neonatal outcomes associated with prepregnancy obesity, and we tested the effect modification of parity on these associations. METHODS: In 2012, 3368 mothers who had delivered in 136 randomly selected maternity wards were included just after birth in the French birth cohort, Epifane. Maternal height and weight before and at the last month of pregnancy were self-reported. Maternal and neonatal outcomes were collected in medical records. Prepregnancy Body Mass Index (pBMI) was classified into underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9) and obesity (≥30.0). Since we found statistically significant interactions with parity, the multinomial logistic regression model estimating associations of pBMI class with sociodemographic characteristics and pregnancy outcomes was stratified on parity (1335 primiparous and 1814 multiparous). RESULTS: Before pregnancy, 7.6% of women were underweight, 64.2% were of normal weight, 18.0% were overweight and 10.2% were obese. Among the primiparous, maternal age of 25-29 years (OR = 2.09 [1.13-3.87]; vs. 30-34 years), high school level (OR = 2.22 [1.33-3.73]; vs. university level), gestational diabetes (OR = 2.80 [1.56-5.01]) and hypertensive complications (OR = 3.80 [1.83-7.89]) were independently associated with prepregnancy obesity. Among the multiparous, primary (OR = 6.30 [2.40-16.57]), junior high (OR = 2.89 [1.81-4.64]) and high school (OR = 1.86 [1.18-2.93]) education levels (vs. university level), no attendance at antenatal classes (OR = 1.77 [1.16-2.72]), excess gestational weight gain (OR = 1.82 [1.20-2.76]), gestational diabetes (OR =5.16 [3.15-8.46]), hypertensive complications (OR = 8.13 [3.97-16.64]), caesarean delivery (OR = 1.80 [1.18-2.77]) and infant birth weight ≥ 4 kg (OR = 1.70 [1.03-2.80]; vs. birth weight between 2.5 kg and 4 kg) were independently associated with prepregnancy obesity. CONCLUSION: Obesity before pregnancy is associated with a set of sociodemographic characteristics and adverse pregnancy outcomes that differ across parity groups. Such findings are useful for targeted health policies aimed at attaining healthy prepregnancy weight and organizing perinatal care. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/28841845/Sociodemographic_factors_and_pregnancy_outcomes_associated_with_prepregnancy_obesity:_effect_modification_of_parity_in_the_nationwide_Epifane_birth_cohort_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1456-8 DB - PRIME DP - Unbound Medicine ER -