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Impact of Pregestational Weight and Weight Gain during Pregnancy on Long-Term Risk for Diseases

1 , 2 , 1 , 3 , 1 , 2 , *

PLoS ONE

Public Library of Science

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      Abstract

      ObjectiveThe aim of this study was to analyse the impact of maternal BMI at start of pregnancy and maternal weight gain during pregnancy on the risk of various diseases later in life.MethodsIn a population-based cohort from southern Sweden, women with at least one delivery registered in the Swedish Medical Birth Register ten or more years before answering a health questionnaire were identified (n = 13,608). Complete data were found in 3,539 women.ResultsWomen with BMI >25 at start of pregnancy had increased risk of developing obesity (OR 21.9), diabetes (OR 6.4), cardiac disease (OR 2.7), endocrine diseases (OR 2.3), and other morbidity (OR 1.4), compared with women of normal weight. A high weight gain (>15 kg) during pregnancy was associated to later risk of overweight (OR 2.0) and obesity (OR 2.2), but not diabetes, cardiac disease, or endocrine diseases. A positive association was found between low weight gain and the risk of developing psychiatric disorders (OR 1.6).ConclusionsA high BMI at start of pregnancy significantly increased the risk of several diseases later in life. However, a high weight gain during pregnancy was only significant for future overweight and obesity. These findings have implications for both pregestational intervention and post gestational follow up of obese and overweight women.

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      Most cited references 30

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      Predicting obesity in young adulthood from childhood and parental obesity.

      Childhood obesity increases the risk of obesity in adulthood, but how parental obesity affects the chances of a child's becoming an obese adult is unknown. We investigated the risk of obesity in young adulthood associated with both obesity in childhood and obesity in one or both parents. Height and weight measurements were abstracted from the records of 854 subjects born at a health maintenance organization in Washington State between 1965 and 1971. Their parents' medical records were also reviewed. Childhood obesity was defined as a body-mass index at or above the 85th percentile for age and sex, and obesity in adulthood as a mean body-mass index at or above 27.8 for men and 27.3 for women. In young adulthood (defined as 21 to 29 years of age), 135 subjects (16 percent) were obese. Among those who were obese during childhood, the chance of obesity in adulthood ranged from 8 percent for 1- or 2-year-olds without obese parents to 79 percent for 10-to-14-year-olds with at least one obese parent. After adjustment for parental obesity, the odds ratios for obesity in adulthood associated with childhood obesity ranged from 1.3 (95 percent confidence interval, 0.6 to 3.0) for obesity at 1 or 2 years of age to 17.5 (7.7 to 39.5) for obesity at 15 to 17 years of age. After adjustment for the child's obesity status, the odds ratios for obesity in adulthood associated with having one obese parent ranged from 2.2 (95 percent confidence interval, 1.1 to 4.3) at 15 to 17 years of age to 3.2 (1.8 to 5.7) at 1 or 2 years of age. Obese children under three years of age without obese parents are at low risk for obesity in adulthood, but among older children, obesity is an increasingly important predictor of adult obesity, regardless of whether the parents are obese. Parental obesity more than doubles the risk of adult obesity among both obese and nonobese children under 10 years of age.
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        Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy.

        Although both maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) may affect birth weight, their separate and joint associations with complications of pregnancy and delivery and with postpartum weight retention are unclear. We aimed to investigate the combined associations of prepregnancy BMI and GWG with pregnancy outcomes and to evaluate the trade-offs between mother and infant for different weight gains. Data for 60892 term pregnancies in the Danish National Birth Cohort were linked to birth and hospital discharge registers. Self-reported total GWG was categorized as low ( or=20 kg). Adjusted associations of prepregnancy BMI and GWG with outcomes of interest were estimated by logistic regression analyses. High and very high GWG added to the associations of high prepregnancy BMI with cesarean delivery and were strongly associated with high postpartum weight retention. Moreover, greater weight gains and high maternal BMI decreased the risk of growth restriction and increased the risk of the infant's being born large-for-gestational-age or with a low Apgar score. Generally, low GWG was advantageous for the mother, but it increased the risk of having a small baby, particularly for underweight women. Heavier women may benefit from avoiding high and very high GWG, which brings only a slight increase in the risk of growth restriction for the infant. High weight gain in underweight women does not appear to have deleterious consequences for them or their infants, but they may want to avoid low GWG to prevent having a small baby.
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          Effects of gestational weight gain and body mass index on obstetric outcome in Sweden.

           M Cedergren (2006)
          The objective of this study was to estimate the effects of low and high gestational weight gain, in different maternal Body Mass Index (BMI) classes, on obstetric and neonatal outcomes. A prospective population-based cohort study of 245,526 singleton term pregnancies. Women were grouped in five categories of BMI and in three gestational weight gain categories; 16 kg (high weight gain). Obstetric and neonatal outcomes were evaluated after adjustments for maternal age, parity, smoking, year of birth. Obese women with low gestational weight gain had a decreased risk for the following outcomes (adjusted odds ratio; 95% confidence interval): preeclampsia (0.52; 0.42-0.62), cesarean section (0.81; 0.73-0.90), instrumental delivery (0.75; 0.63-0.88), and LGA births (0.66; 0.59-0.75). There was a 2-fold increased risk for preeclampsia and LGA infants among average and overweight women with excessive weight gain. High gestational weight gain increased the risk for cesarean delivery in all maternal BMI classes. The effects of high or low gestational weight gain differ depending on maternal BMI and the outcome variable studied. Obese women may benefit from a low weight gain during pregnancy.
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            Author and article information

            Affiliations
            [1 ]Department of Clinical Sciences, Lund University, Lund, Sweden
            [2 ]Department of Endocrinology, Skane University Hospital, Lund, Sweden
            [3 ]Department of Oncology, Skane University Hospital, Lund, Sweden
            Centro Cardiologico Monzino, ITALY
            Author notes

            Competing Interests: The authors have declared that no competing interests exist.

            • Conceptualization: UM HO MLO.

            • Data curation: UM MLO.

            • Formal analysis: UM MLO.

            • Funding acquisition: MLO.

            • Investigation: HO UM MLO.

            • Methodology: MLO UM.

            • Project administration: MLO.

            • Resources: HO MLO.

            • Software: UM MLO.

            • Supervision: MLO.

            • Validation: UM MLO.

            • Visualization: UM.

            • Writing – original draft: UM.

            • Writing – review & editing: UM.

            Contributors
            Role: Editor
            Journal
            PLoS One
            PLoS ONE
            plos
            plosone
            PLoS ONE
            Public Library of Science (San Francisco, CA USA )
            1932-6203
            3 January 2017
            2017
            : 12
            : 1
            28045917
            5207749
            10.1371/journal.pone.0168543
            PONE-D-16-13842
            (Editor)
            © 2017 Moll et al

            This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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            Figures: 2, Tables: 4, Pages: 12
            Product
            Funding
            Funded by: Research funds from Region Skane
            Funded by: ALF Foundation at Lund University
            The study was funded by research funds from Lund University and University Hospital. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
            Categories
            Research Article
            Medicine and Health Sciences
            Women's Health
            Maternal Health
            Pregnancy
            Medicine and Health Sciences
            Women's Health
            Obstetrics and Gynecology
            Pregnancy
            Biology and Life Sciences
            Physiology
            Physiological Parameters
            Body Weight
            Body Mass Index
            Medicine and Health Sciences
            Physiology
            Physiological Parameters
            Body Weight
            Body Mass Index
            Biology and Life Sciences
            Physiology
            Physiological Parameters
            Body Weight
            Obesity
            Medicine and Health Sciences
            Physiology
            Physiological Parameters
            Body Weight
            Obesity
            Biology and Life Sciences
            Physiology
            Physiological Parameters
            Body Weight
            Weight Gain
            Medicine and Health Sciences
            Physiology
            Physiological Parameters
            Body Weight
            Weight Gain
            Medicine and Health Sciences
            Endocrinology
            Endocrine Disorders
            Diabetes Mellitus
            Medicine and Health Sciences
            Metabolic Disorders
            Diabetes Mellitus
            Medicine and Health Sciences
            Endocrinology
            Endocrine Disorders
            Diabetes Mellitus
            Gestational Diabetes
            Medicine and Health Sciences
            Metabolic Disorders
            Diabetes Mellitus
            Gestational Diabetes
            Medicine and Health Sciences
            Endocrinology
            Diabetic Endocrinology
            Medicine and Health Sciences
            Endocrinology
            Endocrine Physiology
            Reproductive Endocrinology
            Biology and Life Sciences
            Physiology
            Endocrine Physiology
            Reproductive Endocrinology
            Medicine and Health Sciences
            Physiology
            Endocrine Physiology
            Reproductive Endocrinology
            Medicine and Health Sciences
            Endocrinology
            Reproductive Endocrinology
            Custom metadata
            The data set used contains sensitive personal information and we are for ethical reasons not allowed to share the data. Prof Mona Landin-Olsson may be contacted to request access to confidential data at: mona.landin-olsson@ 123456med.lu.se . Further contact information here: Prof Mona Landin-Olsson, Dept of Endocrinology, Skane University Hospital, SE-221 85 Lund, Sweden, phone +4646-171452 or +4646171000.

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