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A cohort study of high maternal Body Mass Index and the risk of adverse pregnancy and delivery outcomes in Scotland

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Date
20/02/2020
Author
Doi, Lawrence
Williams, Andrew James
Marryat, Louise
Frank, John
Keywords
RA0421 Public health. Hygiene. Preventive Medicine
RG Gynecology and obstetrics
3rd-DAS
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Abstract
Objective To examine the association between high maternal weight status and complications during pregnancy and delivery. Setting Scotland. Participants Data from 132 899 first-time singleton deliveries in Scotland between 2008 and 2015 were used. Women with overweight and obesity were compared with women with normal weight. Associations between maternal body mass index and complications during pregnancy and delivery were evaluated. Outcome measures Gestational diabetes, gestational hypertension, pre-eclampsia, placenta praevia, placental abruption, induction of labour, elective and emergency caesarean sections, pre-term delivery, post-term delivery, low Apgar score, small for gestational age and large for gestational age. Results In the multivariable models controlling for potential confounders, we found that, compared with women with normal weight, the odds of the following outcomes were significantly increased for women with overweight and obesity (overweight adjusted ORs; 95% CI, followed by the same for women with obesity): gestational hypertension (1.61; 1.49 to 1.74), (2.48; 2.30 to 2.68); gestational diabetes (2.14; 1.86 to 2.46), (8.25; 7.33 to 9.30); pre-eclampsia (1.46; 1.32 to 1.63) (2.07; 1.87 to 2.29); labour induction (1.28; 1.23 to 1.33), (1.69; 1.62 to 1.76) and emergency caesarean section (1.82; 1.74 to 1.91), (3.14; 3.00 to 3.29). Conclusions Women with overweight and obesity in Scotland are at greater odds of adverse pregnancy and delivery outcomes. The odds of these conditions increases with increasing body mass index. Health professionals should be empowered and trained to deliver promising dietary and lifestyle interventions to women at risk of overweight and obesity prior to conception, and control excessive weight gain in pregnancy.
Citation
Doi , L , Williams , A J , Marryat , L & Frank , J 2020 , ' A cohort study of high maternal Body Mass Index and the risk of adverse pregnancy and delivery outcomes in Scotland ' , BMJ Open , vol. 10 , no. 2 , e026168 . https://doi.org/10.1136/bmjopen-2018-026168
Publication
BMJ Open
Status
Peer reviewed
DOI
https://doi.org/10.1136/bmjopen-2018-026168
ISSN
2044-6055
Type
Journal article
Rights
Copyright © Author(s) (or their employer(s)) 2020. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Description
Funding: SCPHRP core grant from the Medical Research Council (Grant Number MR/K023209/1) and the Chief Scientist Office of Scotland. AJW is supported by the European Centre for Environment and Human Health, University of Exeter. LM is supported by the Farr Institute @ Scotland, which is supported by a 10-funder consortium: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates), (MRC Grant No: MR/K007017/1).
Collections
  • University of St Andrews Research
URI
http://hdl.handle.net/10023/19524

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