المؤلفون: Santos S; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands., Voerman E; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands., Amiano P; Public Health Division of Gipuzkoa, San Sebastián, Spain.; BioDonostia Research Institute, San Sebastián, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Barros H; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.; Department of Public Health and Forensic Sciences and Medical Education, Unit of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal., Beilin LJ; Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia., Bergström A; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden., Charles MA; INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Villejuif, France.; Paris Descartes University, Villejuif, France., Chatzi L; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.; Faculty of Medicine, Department of Social Medicine, University of Crete, Heraklion, Greece.; Department of Genetics and Cell Biology, Maastricht University, Maastricht, the Netherlands., Chevrier C; Inserm UMR 1085, Irset - Research Institute for Environmental and Occupational Health, Rennes, France., Chrousos GP; First Department of Pediatrics, Athens University Medical School, 'Aghia Sophia' Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece., Corpeleijn E; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Costa O; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain., Costet N; Inserm UMR 1085, Irset - Research Institute for Environmental and Occupational Health, Rennes, France., Crozier S; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK., Devereux G; Liverpool School of Tropical Medicine, Liverpool, UK., Doyon M; Centre de Recherche du Centre Hospitalier de l'Universite de Sherbrooke, Sherbrooke, QC, Canada., Eggesbø M; Department of Exposure and Environmental Epidemiology, Norwegian Institute of Public Health, Oslo, Norway., Fantini MP; The Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy., Farchi S; Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Forastiere F; Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Georgiu V; Faculty of Medicine, Department of Social Medicine, University of Crete, Heraklion, Greece., Godfrey KM; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK., Gori D; The Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy., Grote V; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-Universität Munich, Munich, Germany., Hanke W; Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland., Hertz-Picciotto I; Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA., Heude B; INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Villejuif, France.; Paris Descartes University, Villejuif, France., Hivert MF; Centre de Recherche du Centre Hospitalier de l'Universite de Sherbrooke, Sherbrooke, QC, Canada.; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.; Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA., Hryhorczuk D; Center for Global Health, University of Illinois College of Medicine, Chicago, IL, USA., Huang RC; Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia., Inskip H; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK., Karvonen AM; Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland., Kenny LC; Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.; Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland., Koletzko B; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilian-Universität Munich, Munich, Germany., Küpers LK; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.; MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, University of Bristol, Bristol, UK.; Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands., Lagström H; Department of Public Health, University of Turku, Turku, Finland., Lehmann I; Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany., Magnus P; Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway., Majewska R; Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland., Mäkelä J; Turku Centre for Biotechnology, University of Turku and Abo Akademi University, Turku, Finland., Manios Y; Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece., McAuliffe FM; UCD Perinatal Research Centre, Obstetrics& Gynaecology, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland., McDonald SW; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada., Mehegan J; UCD Perinatal Research Centre, School of Public Health and Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland., Melén E; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.; Sach's Children Hospital, Stockholm, Sweden., Mommers M; Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands., Morgen CS; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark., Moschonis G; Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Vic, Australia., Murray D; Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.; Paediatrics & Child Health, University College Cork, Cork, Ireland., Ní Chaoimh C; Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.; Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland., Nohr EA; Research Unit for Gynaecology and Obstetrics, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark., Nybo Andersen AM; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark., Oken E; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA., Oostvogels A; Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam, the Netherlands., Pac A; Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland., Papadopoulou E; Department of Environmental Exposures and Epidemiology, Domain of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway., Pekkanen J; Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland.; Department of Public Health, University of Helsinki, Helsinki, Finland., Pizzi C; Department of Medical Sciences, University of Turin, Turin, Italy., Polanska K; Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland., Porta D; Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Richiardi L; Department of Medical Sciences, University of Turin, Turin, Italy., Rifas-Shiman SL; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA., Roeleveld N; Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands., Ronfani L; Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', Trieste, Italy., Santos AC; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.; Department of Public Health and Forensic Sciences and Medical Education, Unit of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal., Standl M; Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany., Stigum H; Department of Non-communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway., Stoltenberg C; Norwegian Institute of Public Health, Oslo, Norway.; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway., Thiering E; Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.; Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany., Thijs C; Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands., Torrent M; Ib-salut, Area de Salut de Menorca, Menorca, Spain., Tough SC; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada., Trnovec T; Department of Environmental Medicine, Slovak Medical University, Bratislava, Slovak Republic., Turner S; Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK., van Gelder M; Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.; Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands., van Rossem L; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands., von Berg A; Department of Pediatrics, Research Institute, Marien-Hospital Wesel, Wesel, Germany., Vrijheid M; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; ISGlobal, Institute for Global Health, Barcelona, Spain.; Universitat Pompeu Fabra (UPF), Barcelona, Spain., Vrijkotte T; Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam, the Netherlands., West J; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK., Wijga AH; National Institute for Public Health and the Environment, Bilthoven, the Netherlands., Wright J; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK., Zvinchuk O; Department of Medical and Social Problems of Family Health, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv, Ukraine., Sørensen T; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.; Section of Metabolic Genetics, Faculty of Health and Medical Sciences, The Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark., Lawlor DA; MRC Integrative Epidemiology Unit, Oakfield House, Oakfield Grove, University of Bristol, Bristol, UK.; Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK., Gaillard R; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands., Jaddoe V; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.; Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.

المصدر: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2019 Jul; Vol. 126 (8), pp. 984-995. Date of Electronic Publication: 2019 Mar 20.

نوع المنشور: Journal Article; Meta-Analysis

بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 100935741 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-0528 (Electronic) Linking ISSN: 14700328 NLM ISO Abbreviation: BJOG Subsets: MEDLINE

مواضيع طبية MeSH: Body Mass Index*, Gestational Weight Gain/*physiology , Overweight/*complications , Pregnancy Complications/*etiology, Adult ; Australia/epidemiology ; Birth Weight ; Cohort Studies ; Europe/epidemiology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; North America/epidemiology ; Odds Ratio ; Pregnancy ; Pregnancy Complications/epidemiology ; Risk Factors

مستخلص: 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.
(© 2019 Royal College of Obstetricians and Gynaecologists.)

المؤلفون: Voerman E; The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, the Netherlands., Santos S; The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, the Netherlands., Patro Golab B; The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland., Amiano P; Public Health Division of Gipuzkoa, San Sebastián, Spain.; BioDonostia Research Institute, San Sebastián, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Ballester F; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain., Barros H; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.; Department of Public Health and Forensic Sciences and Medical Education, Unit of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal., Bergström A; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden., Charles MA; INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Villejuif, France.; Paris Descartes University, Villejuif, France., Chatzi L; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America.; Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.; Department of Genetics and Cell Biology, Maastricht University, Maastricht, the Netherlands., Chevrier C; INSERM, UMR1085, Irset-Research Institute for Environmental and Occupational Health, Rennes, France., Chrousos GP; First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece., Corpeleijn E; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Costet N; INSERM, UMR1085, Irset-Research Institute for Environmental and Occupational Health, Rennes, France., Crozier S; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom., Devereux G; Liverpool School of Tropical Medicine, Liverpool, United Kingdom., Eggesbø M; Department of Exposure and Environmental Epidemiology, Norwegian Institute of Public Health, Oslo, Norway., Ekström S; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden., Fantini MP; The Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy., Farchi S; Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Forastiere F; Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Georgiu V; Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece., Godfrey KM; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom., Gori D; The Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy., Grote V; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany., Hanke W; Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland., Hertz-Picciotto I; Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California, United States of America., Heude B; INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), ORCHAD Team, Villejuif, France.; Paris Descartes University, Villejuif, France., Hryhorczuk D; Center for Global Health, University of Illinois College of Medicine, Chicago, Illinois, United States of America., Huang RC; Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia., Inskip H; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom., Iszatt N; Department of Exposure and Environmental Epidemiology, Norwegian Institute of Public Health, Oslo, Norway., Karvonen AM; Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland., Kenny LC; Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.; Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland., Koletzko B; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany., Küpers LK; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.; Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom.; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom., Lagström H; Department of Public Health, University of Turku, Turku, Finland., Lehmann I; Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany., Magnus P; Division of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway., Majewska R; Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland., Mäkelä J; Turku Centre for Biotechnology, University of Turku and Abo Akademi University, Turku, Finland., Manios Y; Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece., McAuliffe FM; UCD Perinatal Research Centre, Obstetrics & Gynaecology, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland., McDonald SW; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Mehegan J; UCD Perinatal Research Centre, School of Public Health and Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland., Mommers M; Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands., Morgen CS; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark., Mori TA; Medical School, The University of Western Australia, Perth, Western Australia, Australia., Moschonis G; Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Victoria, Australia., Murray D; Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.; Paediatrics & Child Health, University College Cork, Cork, Ireland., Chaoimh CN; Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.; Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland., Nohr EA; Research Unit for Gynaecology and Obstetrics, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark., Nybo Andersen AM; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark., Oken E; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America., Oostvogels AJJM; Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam, the Netherlands., Pac A; Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland., Papadopoulou E; Department of Environmental Exposures and Epidemiology, Domain of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway., Pekkanen J; Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland.; Department of Public Health, University of Helsinki, Helsinki, Finland., Pizzi C; Department of Medical Sciences, University of Turin, Turin, Italy., Polanska K; Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland., Porta D; Department of Epidemiology, Lazio Regional Health Service, Rome, Italy., Richiardi L; Department of Medical Sciences, University of Turin, Turin, Italy., Rifas-Shiman SL; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America., Ronfani L; Institute for Maternal and Child Health-IRCCS 'Burlo Garofolo', Trieste, Italy., Santos AC; EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.; Department of Public Health and Forensic Sciences and Medical Education, Unit of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal., Standl M; Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany., Stoltenberg C; Norwegian Institute of Public Health, Oslo, Norway.; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway., Thiering E; Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.; Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, Germany., Thijs C; Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands., Torrent M; IB-Salut, Area de Salut de Menorca, Palma, Spain., Tough SC; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada., Trnovec T; Department of Environmental Medicine, Slovak Medical University, Bratislava, Slovak Republic., Turner S; Child Health, Royal Aberdeen Children's Hospital, Aberdeen, United Kingdom., van Rossem L; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands., von Berg A; Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany., Vrijheid M; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.; ISGlobal, Barcelona, Spain.; Universitat Pompeu Fabra (UPF), Barcelona, Spain., Vrijkotte TGM; Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam, the Netherlands., West J; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom., Wijga A; National Institute for Public Health and the Environment, Bilthoven, the Netherlands., Wright J; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom., Zvinchuk O; Department of Medical and Social Problems of Family Health, Institute of Pediatrics, Obstetrics and Gynecology, Kyiv, Ukraine., Sørensen TIA; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark.; The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Lawlor DA; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom.; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom., Gaillard R; The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, the Netherlands., Jaddoe VWV; The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, the Netherlands.; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.

المصدر: PLoS medicine [PLoS Med] 2019 Feb 11; Vol. 16 (2), pp. e1002744. Date of Electronic Publication: 2019 Feb 11 (Print Publication: 2019).

نوع المنشور: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101231360 Publication Model: eCollection Cited Medium: Internet ISSN: 1549-1676 (Electronic) Linking ISSN: 15491277 NLM ISO Abbreviation: PLoS Med Subsets: MEDLINE

مواضيع طبية MeSH: Body Mass Index* , Data Analysis*, Gestational Weight Gain/*physiology , Pediatric Obesity/*epidemiology, Australia/epidemiology ; Cohort Studies ; Europe/epidemiology ; Female ; Humans ; North America/epidemiology ; Overweight/diagnosis ; Overweight/epidemiology ; Pediatric Obesity/diagnosis ; Pregnancy ; Risk Factors

مستخلص: Background: Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact.
Methods and Findings: We conducted an individual participant data meta-analysis of data from 162,129 mothers and their children from 37 pregnancy and birth cohort studies from Europe, North America, and Australia. We assessed the individual and combined associations of maternal pre-pregnancy BMI and gestational weight gain, both in clinical categories and across their full ranges, with the risks of overweight/obesity in early (2.0-5.0 years), mid (5.0-10.0 years) and late childhood (10.0-18.0 years), using multilevel binary logistic regression models with a random intercept at cohort level adjusted for maternal sociodemographic and lifestyle-related characteristics. We observed that higher maternal pre-pregnancy BMI and gestational weight gain both in clinical categories and across their full ranges were associated with higher risks of childhood overweight/obesity, with the strongest effects in late childhood (odds ratios [ORs] for overweight/obesity in early, mid, and late childhood, respectively: OR 1.66 [95% CI: 1.56, 1.78], OR 1.91 [95% CI: 1.85, 1.98], and OR 2.28 [95% CI: 2.08, 2.50] for maternal overweight; OR 2.43 [95% CI: 2.24, 2.64], OR 3.12 [95% CI: 2.98, 3.27], and OR 4.47 [95% CI: 3.99, 5.23] for maternal obesity; and OR 1.39 [95% CI: 1.30, 1.49], OR 1.55 [95% CI: 1.49, 1.60], and OR 1.72 [95% CI: 1.56, 1.91] for excessive gestational weight gain). The proportions of childhood overweight/obesity prevalence attributable to maternal overweight, maternal obesity, and excessive gestational weight gain ranged from 10.2% to 21.6%. Relative to the effect of maternal BMI, excessive gestational weight gain only slightly increased the risk of childhood overweight/obesity within each clinical BMI category (p-values for interactions of maternal BMI with gestational weight gain: p = 0.038, p < 0.001, and p = 0.637 in early, mid, and late childhood, respectively). Limitations of this study include the self-report of maternal BMI and gestational weight gain for some of the cohorts, and the potential of residual confounding. Also, as this study only included participants from Europe, North America, and Australia, results need to be interpreted with caution with respect to other populations.
Conclusions: In this study, higher maternal pre-pregnancy BMI and gestational weight gain were associated with an increased risk of childhood overweight/obesity, with the strongest effects at later ages. The additional effect of gestational weight gain in women who are overweight or obese before pregnancy is small. Given the large population impact, future intervention trials aiming to reduce the prevalence of childhood overweight and obesity should focus on maternal weight status before pregnancy, in addition to weight gain during pregnancy.
Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: KMG has received reimbursement for speaking at conferences sponsored by companies selling nutritional products, and is part of an academic consortium that has received research funding from Abbott Nutrition, Nestec and Danone. HL has participated as an advisory board member, consultant and speaker for Nestlé Nutrition Institute and Nestlé Finland. DAL has received support from several National and International Government and Charity Funders and from Roche Diagnostics and Medtronic for research unrelated to that presented here. All support had been administered via DAL's institution; not directly to her. The other authors have declared that no competing interests exist.