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

S. Santos, E. Voerman, P. Amiano, H. Barros, L.J. Beilin, A. Bergström, M.A. Charles, L. Chatzi, C. Chevrier, G.P. Chrousos, E. Corpeleijn, O. Costa, N. Costet, S. Crozier, G. Devereux, M. Doyon, M. Eggesbø, M.P. Fantini, S. Farchi, F. Forastiere & 67 others V. Georgiu, K.M. Godfrey, D. Gori, V. Grote, W. Hanke, I. Hertz-Picciotto, B. Heude, M.F. Hivert, D. Hryhorczuk, R.C. Huang, H. Inskip, A.M. Karvonen, L.C. Kenny, B. Koletzko, L.K. Küpers, H. Lagström, I. Lehmann, P. Magnus, R. Majewska, J. Mäkelä, Y. Manios, F.M. McAuliffe, S.W. McDonald, J. Mehegan, E. Melén, M. Mommers, C.S. Morgen, G. Moschonis, D. Murray, C. Ní Chaoimh, E.A. Nohr, A.M. Nybo Andersen, E. Oken, A.J.J.M. Oostvogels, A. Pac, E. Papadopoulou, J. Pekkanen, C. Pizzi, K. Polanska, D. Porta, L. Richiardi, S.L. Rifas-Shiman, N. Roeleveld, L. Ronfani, A.C. Santos, M. Standl, H. Stigum, C. Stoltenberg, E. Thiering, C. Thijs, M. Torrent, S.C. Tough, T. Trnovec, S. Turner, M.M.H.J. van Gelder, L. van Rossem, A. von Berg, M. Vrijheid, T.G.M. Vrijkotte, J. West, A.H. Wijga, J. Wright, O. Zvinchuk, T.I.A. Sørensen, D.A. Lawlor, R. Gaillard, V.W.V. Jaddoe*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Scopus)

Abstract

Objective: To assess the separate and combined associations of maternal pre-pregnancy body mass index (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 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 for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with 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% CI 2.31– 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large 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 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. Tweetable abstract: Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.

Original languageEnglish
Pages (from-to)984-995
Number of pages12
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume126
Issue number8
DOIs
Publication statusPublished - 1 Jul 2019

Fingerprint

Pregnancy Complications
Weight Gain
Meta-Analysis
Body Mass Index
Mothers
Pregnancy
Gestational Age
High-Risk Pregnancy
Gestational Diabetes
Premature Birth
Parturition
Logistic Models
Oceania
Population
Pregnancy Induced Hypertension
North America
Pre-Eclampsia
Obesity
Odds Ratio
Outcome Assessment (Health Care)

Keywords

  • Birthweight
  • body mass index
  • pregnancy complications
  • preterm birth
  • weight gain

Cite this

Santos, S. ; Voerman, E. ; Amiano, P. ; Barros, H. ; Beilin, L.J. ; Bergström, A. ; Charles, M.A. ; Chatzi, L. ; Chevrier, C. ; Chrousos, G.P. ; Corpeleijn, E. ; Costa, O. ; Costet, N. ; Crozier, S. ; Devereux, G. ; Doyon, M. ; Eggesbø, M. ; Fantini, M.P. ; Farchi, S. ; Forastiere, F. ; Georgiu, V. ; Godfrey, K.M. ; Gori, D. ; Grote, V. ; Hanke, W. ; Hertz-Picciotto, I. ; Heude, B. ; Hivert, M.F. ; Hryhorczuk, D. ; Huang, R.C. ; Inskip, H. ; Karvonen, A.M. ; Kenny, L.C. ; Koletzko, B. ; Küpers, L.K. ; Lagström, H. ; Lehmann, I. ; Magnus, P. ; Majewska, R. ; Mäkelä, J. ; Manios, Y. ; McAuliffe, F.M. ; McDonald, S.W. ; Mehegan, J. ; Melén, E. ; Mommers, M. ; Morgen, C.S. ; Moschonis, G. ; Murray, D. ; Ní Chaoimh, C. ; Nohr, E.A. ; Nybo Andersen, A.M. ; Oken, E. ; Oostvogels, A.J.J.M. ; Pac, A. ; Papadopoulou, E. ; Pekkanen, J. ; Pizzi, C. ; Polanska, K. ; Porta, D. ; Richiardi, L. ; Rifas-Shiman, S.L. ; Roeleveld, N. ; Ronfani, L. ; Santos, A.C. ; Standl, M. ; Stigum, H. ; Stoltenberg, C. ; Thiering, E. ; Thijs, C. ; Torrent, M. ; Tough, S.C. ; Trnovec, T. ; Turner, S. ; van Gelder, M.M.H.J. ; van Rossem, L. ; von Berg, A. ; Vrijheid, M. ; Vrijkotte, T.G.M. ; West, J. ; Wijga, A.H. ; Wright, J. ; Zvinchuk, O. ; Sørensen, T.I.A. ; Lawlor, D.A. ; Gaillard, R. ; Jaddoe, V.W.V. / 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. In: BJOG: An International Journal of Obstetrics and Gynaecology. 2019 ; Vol. 126, No. 8. pp. 984-995.
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abstract = "Objective: To assess the separate and combined associations of maternal pre-pregnancy body mass index (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 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 for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with 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{\%} CI 2.31– 2.74). We estimated that 23.9{\%} of any pregnancy complication was attributable to maternal overweight/obesity and 31.6{\%} of large 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 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. Tweetable abstract: Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.",
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author = "S. Santos and E. Voerman and P. Amiano and H. Barros and L.J. Beilin and A. Bergstr{\"o}m and M.A. Charles and L. Chatzi and C. Chevrier and G.P. Chrousos and E. Corpeleijn and O. Costa and N. Costet and S. Crozier and G. Devereux and M. Doyon and M. Eggesb{\o} and M.P. Fantini and S. Farchi and F. Forastiere and V. Georgiu and K.M. Godfrey and D. Gori and V. Grote and W. Hanke and I. Hertz-Picciotto and B. Heude and M.F. Hivert and D. Hryhorczuk and R.C. Huang and H. Inskip and A.M. Karvonen and L.C. Kenny and B. Koletzko and L.K. K{\"u}pers and H. Lagstr{\"o}m and I. Lehmann and P. Magnus and R. Majewska and J. M{\"a}kel{\"a} and Y. Manios and F.M. McAuliffe and S.W. McDonald and J. Mehegan and E. Mel{\'e}n and M. Mommers and C.S. Morgen and G. Moschonis and D. Murray and {N{\'i} Chaoimh}, C. and E.A. Nohr and {Nybo Andersen}, A.M. and E. Oken and A.J.J.M. Oostvogels and A. Pac and E. Papadopoulou and J. Pekkanen and C. Pizzi and K. Polanska and D. Porta and L. Richiardi and S.L. Rifas-Shiman and N. Roeleveld and L. Ronfani and A.C. Santos and M. Standl and H. Stigum and C. Stoltenberg and E. Thiering and C. Thijs and M. Torrent and S.C. Tough and T. Trnovec and S. Turner and {van Gelder}, M.M.H.J. and {van Rossem}, L. and {von Berg}, A. and M. Vrijheid and T.G.M. Vrijkotte and J. West and A.H. Wijga and J. Wright and O. Zvinchuk and T.I.A. S{\o}rensen and D.A. Lawlor and R. Gaillard and V.W.V. Jaddoe",
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Santos, S, Voerman, E, Amiano, P, Barros, H, Beilin, LJ, Bergström, A, Charles, MA, Chatzi, L, Chevrier, C, Chrousos, GP, Corpeleijn, E, Costa, O, Costet, N, Crozier, S, Devereux, G, Doyon, M, Eggesbø, M, Fantini, MP, Farchi, S, Forastiere, F, Georgiu, V, Godfrey, KM, Gori, D, Grote, V, Hanke, W, Hertz-Picciotto, I, Heude, B, Hivert, MF, Hryhorczuk, D, Huang, RC, Inskip, H, Karvonen, AM, Kenny, LC, Koletzko, B, Küpers, LK, Lagström, H, Lehmann, I, Magnus, P, Majewska, R, Mäkelä, J, Manios, Y, McAuliffe, FM, McDonald, SW, Mehegan, J, Melén, E, Mommers, M, Morgen, CS, Moschonis, G, Murray, D, Ní Chaoimh, C, Nohr, EA, Nybo Andersen, AM, Oken, E, Oostvogels, AJJM, Pac, A, Papadopoulou, E, Pekkanen, J, Pizzi, C, Polanska, K, Porta, D, Richiardi, L, Rifas-Shiman, SL, Roeleveld, N, Ronfani, L, Santos, AC, Standl, M, Stigum, H, Stoltenberg, C, Thiering, E, Thijs, C, Torrent, M, Tough, SC, Trnovec, T, Turner, S, van Gelder, MMHJ, van Rossem, L, von Berg, A, Vrijheid, M, Vrijkotte, TGM, West, J, Wijga, AH, Wright, J, Zvinchuk, O, Sørensen, TIA, Lawlor, DA, Gaillard, R & Jaddoe, VWV 2019, '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', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 126, no. 8, pp. 984-995. https://doi.org/10.1111/1471-0528.15661

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. / Santos, S.; Voerman, E.; Amiano, P.; Barros, H.; Beilin, L.J.; Bergström, A.; Charles, M.A.; Chatzi, L.; Chevrier, C.; Chrousos, G.P.; Corpeleijn, E.; Costa, O.; Costet, N.; Crozier, S.; Devereux, G.; Doyon, M.; Eggesbø, M.; Fantini, M.P.; Farchi, S.; Forastiere, F.; Georgiu, V.; Godfrey, K.M.; Gori, D.; Grote, V.; Hanke, W.; Hertz-Picciotto, I.; Heude, B.; Hivert, M.F.; Hryhorczuk, D.; Huang, R.C.; Inskip, H.; Karvonen, A.M.; Kenny, L.C.; Koletzko, B.; Küpers, L.K.; Lagström, H.; Lehmann, I.; Magnus, P.; Majewska, R.; Mäkelä, J.; Manios, Y.; McAuliffe, F.M.; McDonald, S.W.; Mehegan, J.; Melén, E.; Mommers, M.; Morgen, C.S.; Moschonis, G.; Murray, D.; Ní Chaoimh, C.; Nohr, E.A.; Nybo Andersen, A.M.; Oken, E.; Oostvogels, A.J.J.M.; Pac, A.; Papadopoulou, E.; Pekkanen, J.; Pizzi, C.; Polanska, K.; Porta, D.; Richiardi, L.; Rifas-Shiman, S.L.; Roeleveld, N.; Ronfani, L.; Santos, A.C.; Standl, M.; Stigum, H.; Stoltenberg, C.; Thiering, E.; Thijs, C.; Torrent, M.; Tough, S.C.; Trnovec, T.; Turner, S.; van Gelder, M.M.H.J.; van Rossem, L.; von Berg, A.; Vrijheid, M.; Vrijkotte, T.G.M.; West, J.; Wijga, A.H.; Wright, J.; Zvinchuk, O.; Sørensen, T.I.A.; Lawlor, D.A.; Gaillard, R.; Jaddoe, V.W.V.

In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 126, No. 8, 01.07.2019, p. 984-995.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - 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

AU - Santos, S.

AU - Voerman, E.

AU - Amiano, P.

AU - Barros, H.

AU - Beilin, L.J.

AU - Bergström, A.

AU - Charles, M.A.

AU - Chatzi, L.

AU - Chevrier, C.

AU - Chrousos, G.P.

AU - Corpeleijn, E.

AU - Costa, O.

AU - Costet, N.

AU - Crozier, S.

AU - Devereux, G.

AU - Doyon, M.

AU - Eggesbø, M.

AU - Fantini, M.P.

AU - Farchi, S.

AU - Forastiere, F.

AU - Georgiu, V.

AU - Godfrey, K.M.

AU - Gori, D.

AU - Grote, V.

AU - Hanke, W.

AU - Hertz-Picciotto, I.

AU - Heude, B.

AU - Hivert, M.F.

AU - Hryhorczuk, D.

AU - Huang, R.C.

AU - Inskip, H.

AU - Karvonen, A.M.

AU - Kenny, L.C.

AU - Koletzko, B.

AU - Küpers, L.K.

AU - Lagström, H.

AU - Lehmann, I.

AU - Magnus, P.

AU - Majewska, R.

AU - Mäkelä, J.

AU - Manios, Y.

AU - McAuliffe, F.M.

AU - McDonald, S.W.

AU - Mehegan, J.

AU - Melén, E.

AU - Mommers, M.

AU - Morgen, C.S.

AU - Moschonis, G.

AU - Murray, D.

AU - Ní Chaoimh, C.

AU - Nohr, E.A.

AU - Nybo Andersen, A.M.

AU - Oken, E.

AU - Oostvogels, A.J.J.M.

AU - Pac, A.

AU - Papadopoulou, E.

AU - Pekkanen, J.

AU - Pizzi, C.

AU - Polanska, K.

AU - Porta, D.

AU - Richiardi, L.

AU - Rifas-Shiman, S.L.

AU - Roeleveld, N.

AU - Ronfani, L.

AU - Santos, A.C.

AU - Standl, M.

AU - Stigum, H.

AU - Stoltenberg, C.

AU - Thiering, E.

AU - Thijs, C.

AU - Torrent, M.

AU - Tough, S.C.

AU - Trnovec, T.

AU - Turner, S.

AU - van Gelder, M.M.H.J.

AU - van Rossem, L.

AU - von Berg, A.

AU - Vrijheid, M.

AU - Vrijkotte, T.G.M.

AU - West, J.

AU - Wijga, A.H.

AU - Wright, J.

AU - Zvinchuk, O.

AU - Sørensen, T.I.A.

AU - Lawlor, D.A.

AU - Gaillard, R.

AU - Jaddoe, V.W.V.

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Objective: To assess the separate and combined associations of maternal pre-pregnancy body mass index (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 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 for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with 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% CI 2.31– 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large 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 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. Tweetable abstract: Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.

AB - Objective: To assess the separate and combined associations of maternal pre-pregnancy body mass index (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 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 for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with 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% CI 2.31– 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large 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 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. Tweetable abstract: Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.

KW - Birthweight

KW - body mass index

KW - pregnancy complications

KW - preterm birth

KW - weight gain

U2 - 10.1111/1471-0528.15661

DO - 10.1111/1471-0528.15661

M3 - Article

VL - 126

SP - 984

EP - 995

JO - BJOG : an international journal of obstetrics and gynaecology

JF - BJOG : an international journal of obstetrics and gynaecology

SN - 1470-0328

IS - 8

ER -