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dc.contributor.authorKhashan, A S
dc.contributor.authorKenny, L C
dc.date.accessioned2012-01-31T16:42:21Z
dc.date.available2012-01-31T16:42:21Z
dc.date.issued2012-01-31T16:42:21Z
dc.identifier.citationEur J Epidemiol. 2009;24(11):697-705. Epub 2009 Aug 4.en_GB
dc.identifier.issn1573-7284 (Electronic)en_GB
dc.identifier.issn0393-2990 (Linking)en_GB
dc.identifier.pmid19653107en_GB
dc.identifier.doi10.1007/s10654-009-9375-2en_GB
dc.identifier.urihttp://hdl.handle.net/10147/206221
dc.description.abstractThe increasing prevalence of obesity is presenting a critical challenge to healthcare services. We examined the effect of Body Mass Index in early pregnancy on adverse pregnancy outcome. We performed a population register-based cohort study using data from the North Western Perinatal survey (N = 99,403 babies born during 2004-2006), based at The University of Manchester, UK. The main outcome measures were Caesarean section delivery, preterm birth, neonatal death, stillbirth, Macrosomia, small for gestational age and large for gestational age. The risk of preterm birth was reduced by almost 10% in overweight (RR = 0.89, [95% CI: 0.83, 0.95]) and obese women (RR = 0.90, [95% CI: 0.84, 0.97]) and was increased in underweight women (RR = 1.33, [95% CI: 1.16, 1.53]). Overweight (RR = 1.17, [95% CI: 1.09, 1.25]), obese (RR = 1.35, [95% CI: 1.25, 1.45]) and morbidly obese (RR = 1.24, [95% CI: 1.02, 1.52]) women had an elevated risk of post-term birth compared to normal women. The risk of fetal macrosomia and operative delivery increased with BMI such that morbidly obese women were at greatest risk of both (RR of macrosomia = 4.78 [95% CI: 3.86, 5.92] and RR of Caesarean section = 1.66 [95% CI: 1.61, 1.71] and a RR of emergency Caesarean section = 1.59 [95% CI: 1.45, 1.75]). Excessive leanness and obesity are associated with different adverse pregnancy outcomes with major maternal and fetal complications. Overweight and obese women have a higher risk of macrosomia and Caesarean delivery and lower risk of preterm delivery. The mechanism underlying this association is unclear and is worthy of further investigation.
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshBirth Weighten_GB
dc.subject.meshBody Mass Indexen_GB
dc.subject.meshCesarean Section/*statistics & numerical dataen_GB
dc.subject.meshCohort Studiesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFetal Macrosomia/epidemiology/*etiologyen_GB
dc.subject.meshGreat Britain/epidemiologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIncidenceen_GB
dc.subject.meshInfant Mortalityen_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshObesity/*complications/epidemiologyen_GB
dc.subject.meshPregnancyen_GB
dc.subject.mesh*Pregnancy Complicationsen_GB
dc.subject.meshRisken_GB
dc.subject.meshStillbirth/*epidemiologyen_GB
dc.subject.meshThinness/*complications/epidemiologyen_GB
dc.subject.meshYoung Adulten_GB
dc.titleThe effects of maternal body mass index on pregnancy outcome.en_GB
dc.contributor.departmentThe Anu Research Centre, Department of Obstetrics and Gynaecology, Cork, University Maternity Hospital, University College Cork, Wilton, Cork, Ireland., a.khashan@ucc.ieen_GB
dc.identifier.journalEuropean journal of epidemiologyen_GB
dc.description.provinceMunster
html.description.abstractThe increasing prevalence of obesity is presenting a critical challenge to healthcare services. We examined the effect of Body Mass Index in early pregnancy on adverse pregnancy outcome. We performed a population register-based cohort study using data from the North Western Perinatal survey (N = 99,403 babies born during 2004-2006), based at The University of Manchester, UK. The main outcome measures were Caesarean section delivery, preterm birth, neonatal death, stillbirth, Macrosomia, small for gestational age and large for gestational age. The risk of preterm birth was reduced by almost 10% in overweight (RR = 0.89, [95% CI: 0.83, 0.95]) and obese women (RR = 0.90, [95% CI: 0.84, 0.97]) and was increased in underweight women (RR = 1.33, [95% CI: 1.16, 1.53]). Overweight (RR = 1.17, [95% CI: 1.09, 1.25]), obese (RR = 1.35, [95% CI: 1.25, 1.45]) and morbidly obese (RR = 1.24, [95% CI: 1.02, 1.52]) women had an elevated risk of post-term birth compared to normal women. The risk of fetal macrosomia and operative delivery increased with BMI such that morbidly obese women were at greatest risk of both (RR of macrosomia = 4.78 [95% CI: 3.86, 5.92] and RR of Caesarean section = 1.66 [95% CI: 1.61, 1.71] and a RR of emergency Caesarean section = 1.59 [95% CI: 1.45, 1.75]). Excessive leanness and obesity are associated with different adverse pregnancy outcomes with major maternal and fetal complications. Overweight and obese women have a higher risk of macrosomia and Caesarean delivery and lower risk of preterm delivery. The mechanism underlying this association is unclear and is worthy of further investigation.


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