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Martínez-Hortelano JA, González PB, Rodríguez-Rojo IC, Garrido-Miguel M, Arenas-Arroyo SND, Sequí-Domínguez I, Martínez-Vizcaíno V, Berlanga-Macías C. Interpregnancy weight change and neonatal and infant outcomes: A systematic review and meta-analysis. Ann Epidemiol 2024; 97:1-10. [PMID: 39002666 DOI: 10.1016/j.annepidem.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE To synthesize evidence regarding the association between interpregnancy weight change (IPWC) in consecutive pregnancies and neonatal or infant outcomes in the subsequent pregnancy. METHODS Search strategy was implemented in MEDLINE, EMBASE, Web of Science, Scopus and Cochrane Library from their inception to 13 November 2023. The most adjusted odds ratio (OR) or risk ratio estimates provided by original studies were used to calculate pooled risk ratios and their corresponding 95 % confidence intervals (CI) with the DerSimonian and Laird random effects method. Publication bias was assessed by funnel plots and Egger's method, and risk of bias was assessed with The NewcastleOttawa Quality Assessment Scale. RESULTS Thirty-seven observational studies were included. Interpregnancy weight loss or gain were associated with large for gestational age (OR: 0.89; 95 % CI: 0.84-0.94; I2 = 83.6 % and OR: 1.33; 95 % CI:1.26-1.40; I2 = 98.9 %), and stillbirth risk (OR: 1.10; 95 % CI: 1.01-1.18; I2 = 0.0 % and OR: 1.21; 95 % CI: 1.09-1.33; I2 = 60.2 %,). CONCLUSIONS Findings highlight the importance of managing weight between interpregnancy periods, although these findings should be interpreted cautiously because of the possible influence of social determinants of health and other factors.
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Affiliation(s)
- José Alberto Martínez-Hortelano
- Universidad de Alcalá, Facultad de Enfermería y Fisioterapia, Departamento de Enfermería y Fisioterapia, Enfermería, Cuidado comunitario y Determinantes Sociales de la Salud, Madrid, Spain; University of Castilla-La Mancha, Health Care and Social Research Center, Cuenca, Spain
| | - Patricia Blázquez González
- Universidad de Alcalá, Facultad de Enfermería y Fisioterapia, Departamento de Enfermería y Fisioterapia, Enfermería, Cuidado comunitario y Determinantes Sociales de la Salud, Madrid, Spain; Department of Nursing, Red Cross University, Madrid, Spain
| | - Inmaculada Concepción Rodríguez-Rojo
- Universidad de Alcalá, Facultad de Enfermería y Fisioterapia, Departamento de Enfermería y Fisioterapia, Enfermería, Cuidado comunitario y Determinantes Sociales de la Salud, Madrid, Spain; Center for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain.
| | - Miriam Garrido-Miguel
- University of Castilla-La Mancha, Health Care and Social Research Center, Cuenca, Spain; Universidad de Castilla-La Mancha, Facultad de Enfermería de Albacete, Albacete, Spain
| | - Sergio Núñez de Arenas-Arroyo
- University of Castilla-La Mancha, Health Care and Social Research Center, Cuenca, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Cuenca, Spain
| | - Irene Sequí-Domínguez
- University of Castilla-La Mancha, Health Care and Social Research Center, Cuenca, Spain; Universidad de Castilla-La Mancha, Facultad de Enfermería de Albacete, Albacete, Spain
| | - Vicente Martínez-Vizcaíno
- University of Castilla-La Mancha, Health Care and Social Research Center, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Carlos Berlanga-Macías
- University of Castilla-La Mancha, Health Care and Social Research Center, Cuenca, Spain; Universidad de Castilla-La Mancha, Facultad de Enfermería de Albacete, Albacete, Spain
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2
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Hedermann G, Hedley PL, Gadsbøll K, Thagaard IN, Krebs L, Hagen CM, Sørensen TIA, Christiansen M, Ekelund CK. Maternal obesity, interpregnancy weight changes and congenital heart defects in the offspring: a nationwide cohort study. Int J Obes (Lond) 2024; 48:1126-1132. [PMID: 38734850 PMCID: PMC11281899 DOI: 10.1038/s41366-024-01531-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 04/18/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE To evaluate the association between maternal BMI and congenital heart defects (CHDs) in the offspring when including live births, stillbirths, aborted and terminated pregnancies and to investigate if maternal interpregnancy weight changes between the first and second pregnancy influences the risk of foetal CHDs. METHODS A nationwide cohort study of all singleton pregnancies in Denmark from 2008 to 2018. Data were retrieved from the Danish Foetal Medicine Database, which included both pre- and postnatal diagnoses of CHDs. Children or foetuses with chromosomal aberrations were excluded. Odds ratios were calculated with logistic regression models for CHDs overall, severe CHDs and five of the most prevalent subtypes of CHDs. RESULTS Of the 547 105 pregnancies included in the cohort, 5 442 had CHDs (1.0%). Risk of CHDs became gradually higher with higher maternal BMI; for BMI 25-29.9 kg/m2, adjusted odds ratio (aOR) 1.17 (95% CI 1.10-1.26), for BMI 30-34.9 kg/m2, aOR 1.21 (95% CI 1.09-1.33), for BMI 35-39.9 kg/m2, aOR 1.29 (95% CI 1.11-1.50) and for BMI ≥ 40 kg/m2, aOR 1.85 (95% CI 1.54-2.21). Data was adjusted for maternal age, smoking status and year of estimated due date. The same pattern was seen for the subgroup of severe CHDs. Among the atrioventricular septal defects (n = 231), an association with maternal BMI ≥ 30 kg/m2 was seen, OR 1.67 (95% CI 1.13-2.44). 109 654 women were identified with their first and second pregnancies in the cohort. Interpregnancy BMI change was associated with the risk of CHDs in the second pregnancy (BMI 2 to < 4 kg/m2: aOR 1.29, 95% CI 1.09-1.53; BMI ≥ 4 kg/m2: aOR 1.36, 95% CI 1.08-1.68). CONCLUSION The risk of foetal CHDs became gradually higher with higher maternal BMI and interpregnancy weight increases above 2 BMI units were also associated with a higher risk of CHDs.
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Affiliation(s)
- Gitte Hedermann
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark.
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Department of Obstetrics and Gynaecology, Slagelse Hospital, Slagelse, Denmark.
| | - Paula L Hedley
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
- Department of Epidemiology, School of Public Health, University of Iowa, Iowa City, IA, USA
| | - Kasper Gadsbøll
- Centre of Foetal Medicine, Department of Obstetrics and Gynaecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ida N Thagaard
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
- Department of Obstetrics and Gynaecology, Nordsjaellands Hospital, Farum, Denmark
| | - Lone Krebs
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital Amager and Hvidovre Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian M Hagen
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Christiansen
- Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
- Department of Epidemiology, School of Public Health, University of Iowa, Iowa City, IA, USA
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte K Ekelund
- Centre of Foetal Medicine, Department of Obstetrics and Gynaecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Regadas CT, Escosteguy CC, Fonseca SC, Pinheiro RS, Coeli CM. Trends in prevalence of gastroschisis in Brazil from 2007 to 2020: A national population-based cross-sectional study. Birth Defects Res 2023; 115:633-646. [PMID: 36757175 DOI: 10.1002/bdr2.2156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Gastroschisis is a congenital abnormality of the abdominal wall which worldwide prevalence is increasing with time. Up to now, young maternal age is the main factor associated with gastroschisis. Brazil has a great proportion of adolescent mothers. OBJECTIVES To estimate prevalence of gastroschisis in Brazil, explore the effect of very young maternal age, and analyze regional distribution and time trends. METHODS Cross-sectional population-based study using data from official national information systems from 2007 to 2020, covering 9,831 gastroschisis cases. Low maternal age was assessed as risk factor through odds ratio. Prevalence time trends by maternal age and geographic area were analyzed using joinpoint regression. RESULTS Overall prevalence of gastroschisis in Brazil was 2.47 per 10,000 births. From first to last biennium, there was a 23% relative increase. Last biennium prevalence was higher in the Central-west region and lower in the Northeast. Compared to mothers of 20-34 years old (YO), the odds-ratio for prevalence and 95% confidence intervals for gastroschisis were, as follows: (a) 10-14 YO-4.9 (4.3,5.5); (b) 15-19 YO-3.6 (3.5,3.8); and (c) 35-49 YO-0.3 (95% CI 0.3, 0.4). CONCLUSIONS Prevalence of gastroschisis in Brazil relatively increased 23% from 2007 to 2020. This happened in all maternal age groups. Differences between regions may be associated to data quality. Young mothers had a higher prevalence of gastroschisis and still higher for those under 15 YO. Mother age over 34 YO was a protective factor.
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Affiliation(s)
- Claudia Tavares Regadas
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil
- Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Nagpal TS, Souza SCS, Moffat M, Hayes L, Nuyts T, Liu RH, Bogaerts A, Dervis S, Piccinini-Vallis H, Adamo KB, Heslehurst N. Does prepregnancy weight change have an effect on subsequent pregnancy health outcomes? A systematic review and meta-analysis. Obes Rev 2022; 23:e13324. [PMID: 34694053 DOI: 10.1111/obr.13324] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022]
Abstract
International guidelines recommend women with an overweight or obese body mass index (BMI) aim to reduce their body weight prior to conception to minimize the risk of adverse perinatal outcomes. Recent systematic reviews have demonstrated that interpregnancy weight gain increases women's risk of developing adverse pregnancy outcomes in their subsequent pregnancy. Interpregnancy weight change studies exclude nulliparous women. This systematic review and meta-analysis was conducted following MOOSE guidelines and summarizes the evidence of the impact of preconception and interpregnancy weight change on perinatal outcomes for women regardless of parity. Sixty one studies met the inclusion criteria for this review and reported 34 different outcomes. We identified a significantly increased risk of gestational diabetes (OR 1.88, 95% CI 1.66, 2.14, I2 = 87.8%), hypertensive disorders (OR 1.46 95% CI 1.12, 1.91, I2 = 94.9%), preeclampsia (OR 1.92 95% CI 1.55, 2.37, I2 = 93.6%), and large-for-gestational-age (OR 1.36, 95% CI 1.25, 1.49, I2 = 92.2%) with preconception and interpregnancy weight gain. Interpregnancy weight loss only was significantly associated with increased risk for small-for-gestational-age (OR 1.29 95% CI 1.11, 1.50, I2 = 89.9%) and preterm birth (OR 1.06 95% CI 1.00, 1.13, I2 = 22.4%). Our findings illustrate the need for effective preconception and interpregnancy weight management support to improve pregnancy outcomes in subsequent pregnancies.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Sara C S Souza
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Malcolm Moffat
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Louise Hayes
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Tinne Nuyts
- Department of Development and Regeneration, Research Unit Woman and Child, KU Leuven, Leuven, Belgium
| | - Rebecca H Liu
- Institute for Health System Solutions & Virtual Care, Women's College Hospital, Toronto, Canada
| | - Annick Bogaerts
- Department of Development and Regeneration, Research Unit Woman and Child, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium.,Faculty of Health, University of Plymouth, Plymouth, UK
| | - Sheila Dervis
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Helena Piccinini-Vallis
- Faculty of Medicine, Departments of Family Medicine and Obstetrics and Gynecology, Dalhousie University, Halifax, Canada
| | - Kristi B Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Nicola Heslehurst
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
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Liu S, Evans J, Boutin A, Luo W, Gheorghe M, Auger N, Arbour L, Moore A, Joseph KS, Little J. Time trends, geographic variation and risk factors for gastroschisis in Canada: A population-based cohort study 2006-2017. Paediatr Perinat Epidemiol 2021; 35:664-673. [PMID: 34472132 PMCID: PMC9291817 DOI: 10.1111/ppe.12800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 06/04/2021] [Accepted: 06/16/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Previous studies showed increases in rates of gastroschisis in Canada in the first decade of the 21st century. OBJECTIVE We sought to examine the epidemiologic characteristics of gastroschisis in Canada in recent years. METHODS We conducted a retrospective population-based cohort study of all livebirths and stillbirths delivered in Canada (excluding Quebec) from 2006 to 2017, with information obtained from the Canadian Institute for Health Information. Gastroschisis rates by maternal age, region of residence, and maternal and infant characteristics were quantified using prevalence rate ratios (RR) and 95% confidence intervals (CI). Log-binomial regression was used to quantify the associations between risk factors and gastroschisis. RESULTS There were 1314 gastroschisis cases among 3 364 116 births. The prevalence rate was 3.7 per 10 000 total births in 2006 and 3.4 per 10 000 total births in 2017, with substantial annual variation in rates. The proportion of mothers aged 20-24 years decreased from 16.5% in 2006 to 11.3% in 2017, while the proportion of mothers aged <20 years halved from 4.8% to 2.3%. The prevalence of gastroschisis at birth remained unchanged among mothers aged <20, 20-24 and 30-49 years but increased among mothers aged 25-29 years. The age-adjusted prevalence rate of gastroschisis increased across the period (for 2016-2017 versus 2006-2007 rate ratio [RR] 1.28, 95% CI 1.05, 1.56), and there was substantial regional variation. Risk factors included problematic use of substances (RR 2.61, 95% CI 2.01, 3.39) and hypothyroidism (RR 2.76, 95% CI 1.56, 4.88). There was a North-to-South difference in gastroschisis prevalence (adjusted RR Far North compared with South 1.54, 95% CI 1.11, 2.15). CONCLUSION Gastroschisis birth prevalence rates in Canada have stabilised in recent years compared with the increase documented previously. The substantial geographic variation and North-to-South difference in gastroschisis prevalence may indicate variation in socio-economic status, lifestyle and nutritional patterns.
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Affiliation(s)
- Shiliang Liu
- Centre for Surveillance and Applied ResearchPublic Health Agency of CanadaOttawaOntarioCanada,School of Epidemiology and Public HealthFaculty of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Jane Evans
- Department of Biochemistry and Medical GeneticsUniversity of ManitobaWinnipegManitobaCanada
| | - Amélie Boutin
- Department of Obstetrics and GynaecologyThe Children's and Women's Hospital of British ColumbiaUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Wei Luo
- Centre for Surveillance and Applied ResearchPublic Health Agency of CanadaOttawaOntarioCanada
| | - Mihaela Gheorghe
- Centre for Surveillance and Applied ResearchPublic Health Agency of CanadaOttawaOntarioCanada
| | - Nathalie Auger
- University of Montreal Hospital Research CentreMontrealQuebecCanada
| | - Laura Arbour
- Department of Medical GeneticsUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Aideen Moore
- The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | - K. S. Joseph
- Department of Obstetrics and GynaecologyThe Children's and Women's Hospital of British ColumbiaUniversity of British ColumbiaVancouverBritish ColumbiaCanada,School of Population and Public HealthUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Julian Little
- School of Epidemiology and Public HealthFaculty of MedicineUniversity of OttawaOttawaOntarioCanada
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