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

Susana Santos; Ellis Voerman; Pilar Amiano; Henrique Barros; Lawrence J Beilin; Anna Bergström; Marie-Aline Charles; Leda Chatzi; Cécile Chevrier; George P Chrousos; Eva Corpeleijn; Olga Costa; Nathalie Costet; Sarah Crozier; Graham Devereux; Myriam Doyon; Merete Eggesbø; Maria Pia Fantini; Sara Farchi; Francesco Forastiere; Vagelis Georgiu; Keith M Godfrey; Davide Gori; Veit Grote; Wojciech Hanke; Irva Hertz-Picciotto; Barbara Heude; Marie-France Hivert; Daniel Hryhorczuk; Rae-Chi Huang; Hazel Inskip; Anne M Karvonen; Louise C Kenny; Berthold Koletzko; Leanne K Küpers; Hanna Lagström; Irina Lehmann; Per Magnus; Renata Majewska; Johanna Mäkelä; Yannis Manios; Fionnuala M McAuliffe; Sheila W McDonald; John Mehegan; Erik Melén; Monique Mommers; Camilla S Morgen; George Moschonis; Deirdre Murray; Carol Ní Chaoimh; Ellen A Nohr; Anne-Marie Nybo Andersen; Emily Oken; Adriëtte J J M Oostvogels; Agnieszka Pac; Eleni Papadopoulou; Juha Pekkanen; Costanza Pizzi; Kinga Polanska; Daniela Porta; Lorenzo Richiardi; Sheryl L Rifas-Shiman; Nel Roeleveld; Luca Ronfani; Ana C Santos; Marie Standl; Hein Stigum; Camilla Stoltenberg; Elisabeth Thiering; Carel Thijs; Maties Torrent; Suzanne C Tough; Tomas Trnovec; Steve Turner; Marleen M H J van Gelder; Lenie van Rossem; Andrea von Berg; Martine Vrijheid; Tanja G M Vrijkotte; Jane West; Alet H Wijga; John Wright; Oleksandr Zvinchuk; Thorkild I A Sørensen; Debbie A Lawlor; Romy Gaillard; Vincent W V Jaddoe

doi: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

Susana Santos
, Ellis Voerman
, Pilar Amiano
, Henrique Barros
, Lawrence J Beilin
, Anna Bergström
, Marie-Aline Charles
, Leda Chatzi
, Cécile Chevrier
, George P Chrousos
, Eva Corpeleijn
, Olga Costa
, Nathalie Costet
, Sarah Crozier
, Graham Devereux
, Myriam Doyon
, Merete Eggesbø
, Maria Pia Fantini
, Sara Farchi
, Francesco Forastiere

Vagelis Georgiu, Keith M Godfrey, Davide Gori, Veit Grote, Wojciech Hanke, Irva Hertz-Picciotto, Barbara Heude, Marie-France Hivert, Daniel Hryhorczuk, Rae-Chi Huang, Hazel Inskip, Anne M Karvonen, Louise C Kenny, Berthold Koletzko, Leanne K Küpers, Hanna Lagström, Irina Lehmann, Per Magnus, Renata Majewska, Johanna Mäkelä, Yannis Manios, Fionnuala M McAuliffe, Sheila W McDonald, John Mehegan, Erik Melén, Monique Mommers, Camilla S Morgen, George Moschonis, Deirdre Murray, Carol Ní Chaoimh, Ellen A Nohr, Anne-Marie Nybo Andersen, Emily Oken, Adriëtte J J M Oostvogels, Agnieszka Pac, Eleni Papadopoulou, Juha Pekkanen, Costanza Pizzi, Kinga Polanska, Daniela Porta, Lorenzo Richiardi, Sheryl L Rifas-Shiman, Nel Roeleveld, Luca Ronfani, Ana C Santos, Marie Standl, Hein Stigum, Camilla Stoltenberg, Elisabeth Thiering, Carel Thijs, Maties Torrent, Suzanne C Tough, Tomas Trnovec, Steve Turner, Marleen M H J van Gelder, Lenie van Rossem, Andrea von Berg, Martine Vrijheid, Tanja G M Vrijkotte, Jane West, Alet H Wijga, John Wright, Oleksandr Zvinchuk, Thorkild I A Sørensen, Debbie A Lawlor, Romy Gaillard, Vincent W V Jaddoe

KI, OUH, Research unit of Gynaecology and Obstetrics

Erasmus University Medical Center Rotterdam
CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain
University of Porto
The University of Western Australia
Stockholm County Council, Stockholm, Sweden
Paris Descartes University
Maastricht University
Inserm UMR 1085, Irset-Research Institute for Environmental and Occupational Health, F-35000, Rennes, France.
National and Kapodistrian University of Athens
University Medical Center Groningen
Foundation for the Promotion of Health and Biomedical Research in the Valencian Region
University of Southampton
Liverpool School of Tropical Medicine
University of Sherbrooke
Norwegian Institute of Public Health
University of Bologna
Lazio Regional Health Service
University of Crete
University Hospital Southampton NHS Foundation Trust
Ludwig-Maximilian University of Munich
Nofer Institute of Occupational Medicine
University of California
Massachusetts General Hospital
University of Illinois at Chicago
Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland.
Cork University Maternity Hospital
Wageningen University
University of Turku
Helmholtz Centre for Environmental Research – UFZ
Jagiellonian University Medical College
Åbo Akademi University
Harokopio University
University College Dublin
University of Calgary
Sachs' Children's Hospital
University of Copenhagen
La Trobe University
University College Cork
Harvard Medical School
Harvard Pilgrim Health Care Institute
VU University Medical Center
University of Helsinki
University of Turin
Radboud University Medical Center
Institute for Maternal and Child Health-IRCCS Burlo Garofolo
Institute of Human Genetics, Helmholtz Zentrum München
University of Bergen
IB-Salut, Area de Salut de Menorca, Palma, Spain.
Slovak Medical University
Royal Aberdeen Children's Hospital
University Medical Center Utrecht
Marien-Hospital Wesel
Pompeu Fabra University
Bradford Institute for Health Research
Rijksinstituut voor Volksgezondheid en Milieu
Department of Medical and Social Problems of Family Health, Institute of Pediatrics, Obstetrics and Gynecology
University of Bristol

Research output: Contribution to journal › Journal article › Research › peer-review

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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.

Original language	English
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Volume	126
Issue number	8
Pages (from-to)	984-995
ISSN	1470-0328
DOIs	https://doi.org/10.1111/1471-0528.15661
Publication status	Published - Jul 2019

Keywords

Birthweight
body mass index
pregnancy complications
preterm birth
weight gain

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10.1111/1471-0528.15661

Open Access VersionAccepted manuscript, 844 KB

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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., ... Jaddoe, V. W. V. (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, 126(8), 984-995. https://doi.org/10.1111/1471-0528.15661

@article{a924297228b249dfad73582ccf336a3b,

title = "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",

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.",

keywords = "Birthweight, body mass index, pregnancy complications, preterm birth, weight gain",

author = "Susana Santos and Ellis Voerman and Pilar Amiano and Henrique Barros and Beilin, \{Lawrence J\} and Anna Bergstr{\"o}m and Marie-Aline Charles and Leda Chatzi and C{\'e}cile Chevrier and Chrousos, \{George P\} and Eva Corpeleijn and Olga Costa and Nathalie Costet and Sarah Crozier and Graham Devereux and Myriam Doyon and Merete Eggesb{\o} and Fantini, \{Maria Pia\} and Sara Farchi and Francesco Forastiere and Vagelis Georgiu and Godfrey, \{Keith M\} and Davide Gori and Veit Grote and Wojciech Hanke and Irva Hertz-Picciotto and Barbara Heude and Marie-France Hivert and Daniel Hryhorczuk and Rae-Chi Huang and Hazel Inskip and Karvonen, \{Anne M\} and Kenny, \{Louise C\} and Berthold Koletzko and K{\"u}pers, \{Leanne K\} and Hanna Lagstr{\"o}m and Irina Lehmann and Per Magnus and Renata Majewska and Johanna M{\"a}kel{\"a} and Yannis Manios and McAuliffe, \{Fionnuala M\} and McDonald, \{Sheila W\} and John Mehegan and Erik Mel{\'e}n and Monique Mommers and Morgen, \{Camilla S\} and George Moschonis and Deirdre Murray and Chaoimh, \{Carol N{\'i}\} and Nohr, \{Ellen A\} and \{Nybo Andersen\}, Anne-Marie and Emily Oken and Oostvogels, \{Adri{\"e}tte J J M\} and Agnieszka Pac and Eleni Papadopoulou and Juha Pekkanen and Costanza Pizzi and Kinga Polanska and Daniela Porta and Lorenzo Richiardi and Rifas-Shiman, \{Sheryl L\} and Nel Roeleveld and Luca Ronfani and Santos, \{Ana C\} and Marie Standl and Hein Stigum and Camilla Stoltenberg and Elisabeth Thiering and Carel Thijs and Maties Torrent and Tough, \{Suzanne C\} and Tomas Trnovec and Steve Turner and \{van Gelder\}, \{Marleen M H J\} and \{van Rossem\}, Lenie and \{von Berg\}, Andrea and Martine Vrijheid and Vrijkotte, \{Tanja G M\} and Jane West and Wijga, \{Alet H\} and John Wright and Oleksandr Zvinchuk and S{\o}rensen, \{Thorkild I A\} and Lawlor, \{Debbie A\} and Romy Gaillard and Jaddoe, \{Vincent W V\}",

year = "2019",

month = jul,

doi = "10.1111/1471-0528.15661",

language = "English",

volume = "126",

pages = "984--995",

journal = "BJOG: An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "Wiley",

number = "8",

}

Santos, S, Voerman, E, Amiano, P, Barros, H, Beilin, LJ, Bergström, A, Charles, M-A, 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, M-F, Hryhorczuk, D, Huang, R-C, 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, Chaoimh, CN, Nohr, EA, Nybo Andersen, A-M, 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, Susana; Voerman, Ellis; Amiano, Pilar et al.
In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 126, No. 8, 07.2019, p. 984-995.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - Impact of maternal body mass index and gestational weight gain on pregnancy complications

T2 - An individual participant data meta-analysis of European, North American and Australian cohorts

AU - Santos, Susana

AU - Voerman, Ellis

AU - Amiano, Pilar

AU - Barros, Henrique

AU - Beilin, Lawrence J

AU - Bergström, Anna

AU - Charles, Marie-Aline

AU - Chatzi, Leda

AU - Chevrier, Cécile

AU - Chrousos, George P

AU - Corpeleijn, Eva

AU - Costa, Olga

AU - Costet, Nathalie

AU - Crozier, Sarah

AU - Devereux, Graham

AU - Doyon, Myriam

AU - Eggesbø, Merete

AU - Fantini, Maria Pia

AU - Farchi, Sara

AU - Forastiere, Francesco

AU - Georgiu, Vagelis

AU - Godfrey, Keith M

AU - Gori, Davide

AU - Grote, Veit

AU - Hanke, Wojciech

AU - Hertz-Picciotto, Irva

AU - Heude, Barbara

AU - Hivert, Marie-France

AU - Hryhorczuk, Daniel

AU - Huang, Rae-Chi

AU - Inskip, Hazel

AU - Karvonen, Anne M

AU - Kenny, Louise C

AU - Koletzko, Berthold

AU - Küpers, Leanne K

AU - Lagström, Hanna

AU - Lehmann, Irina

AU - Magnus, Per

AU - Majewska, Renata

AU - Mäkelä, Johanna

AU - Manios, Yannis

AU - McAuliffe, Fionnuala M

AU - McDonald, Sheila W

AU - Mehegan, John

AU - Melén, Erik

AU - Mommers, Monique

AU - Morgen, Camilla S

AU - Moschonis, George

AU - Murray, Deirdre

AU - Chaoimh, Carol Ní

AU - Nohr, Ellen A

AU - Nybo Andersen, Anne-Marie

AU - Oken, Emily

AU - Oostvogels, Adriëtte J J M

AU - Pac, Agnieszka

AU - Papadopoulou, Eleni

AU - Pekkanen, Juha

AU - Pizzi, Costanza

AU - Polanska, Kinga

AU - Porta, Daniela

AU - Richiardi, Lorenzo

AU - Rifas-Shiman, Sheryl L

AU - Roeleveld, Nel

AU - Ronfani, Luca

AU - Santos, Ana C

AU - Standl, Marie

AU - Stigum, Hein

AU - Stoltenberg, Camilla

AU - Thiering, Elisabeth

AU - Thijs, Carel

AU - Torrent, Maties

AU - Tough, Suzanne C

AU - Trnovec, Tomas

AU - Turner, Steve

AU - van Gelder, Marleen M H J

AU - van Rossem, Lenie

AU - von Berg, Andrea

AU - Vrijheid, Martine

AU - Vrijkotte, Tanja G M

AU - West, Jane

AU - Wijga, Alet H

AU - Wright, John

AU - Zvinchuk, Oleksandr

AU - Sørensen, Thorkild I A

AU - Lawlor, Debbie A

AU - Gaillard, Romy

AU - Jaddoe, Vincent W V

PY - 2019/7

Y1 - 2019/7

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 - Journal article

C2 - 30786138

SN - 1470-0328

VL - 126

SP - 984

EP - 995

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

IS - 8

ER -

Santos S, Voerman E, Amiano P, Barros H, Beilin LJ, Bergström A et al. 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. 2019 Jul;126(8):984-995. doi: 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

Abstract

Keywords

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