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Maternal obesity and excess of fetal growth in pre‐eclampsia
Author(s) -
Rasmussen S,
Irgens LM,
Espinoza J
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12677
Subject(s) - medicine , eclampsia , obstetrics , odds ratio , confidence interval , gestational age , population , pregnancy , gestational diabetes , body mass index , obesity , birth weight , pediatrics , gestation , environmental health , biology , genetics
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 OR s 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 OR s 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 ( OR s 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.