Maternal obesity and excess of fetal growth in pre‐eclampsia. (3rd March 2014)

• Record Type: Journal Article
• Authors: Rasmussen, S; Irgens, LM; Espinoza, J
• Is Part Of: BJOG. Volume 121:Number 11(2014:Nov.)
• Page Start: 1351
• Page End: 1358
• Publication Date: 2014-03-03
• Subjects: Birthweight -- body mass index -- large for gestational age -- pre‐eclampsia; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12677
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: To assess whether the reported excess of large for gestational age (LGA) neonates in pre‐eclamptic women delivering at term is attributable to maternal obesity. Design, setting and population: Population‐based observational study including 77 294 singleton pregnancies registered in the Medical Birth Registry of Norway between 2007 and 2010. Methods: Comparison of birthweight percentiles and z ‐scores between women with and without pre‐eclampsia. Main outcome measures: Odds ratio (OR) of LGA and z ‐scores of birthweight in relation to pre‐eclampsia. Results: Pre‐eclamptic women delivering at term had increased risk of having LGA neonates. Unadjusted ORs with 95% confidence interval (95% CI) of LGA above the 90th and 95th birthweight centiles were 1.4, 95% CI 1.2–1.6 and 1.6, 95% CI 1.3–1.9, respectively. The excess of LGA persisted after including gestational diabetes and diabetes types 1 and 2 in a multivariate analysis (corresponding ORs 1.3, 95% CI 1.1–1.5 and 1.4, 95% CI 1.2–1.7), but disappeared after adjusting for maternal prepregnant body mass index (ORs 1.1, 95% CI 0.9–1.2 and 1.1, 95% CI 0.9–1.3). Conclusions: This study suggests accelerated fetal growth in a subset of pre‐eclamptic women delivering at term. The excess of LGA neonates is attributable to maternal obesity among pre‐eclamptic women delivering at term. The maternal obesity epidemic may lead to an increased prevalence of both pre‐eclampsia and LGA neonates among women delivering at term.