Abstract
Given the increase of women with excess weight or obesity and its possible effects on birth weight, the present study aimed to investigate the association between pregestational maternal body mass index (BMI) and birth weight in a birth cohort from Ribeirão Preto, SP, Brazil. This was a prospective study conducted on 1362 mother-child pairs involving singleton births. The women were evaluated using standardized questionnaires during the second trimester of pregnancy and at the time of childbirth. Information about the newborns was obtained from their medical records. The dependent variable was birth weight, categorized as low, adequate, or high. The independent variable was pregestational maternal BMI, categorized as malnutrition, adequate weight, overweight, and obesity. A multinomial regression model was used to estimate the crude and adjusted relative risk (RR) of low and high birth weight. A high frequency of pregestational excess weight (39.6%) was detected and found to be independently associated with high birth weight (RR=2.13, 95%CI: 1.19-3.80 for overweight and RR=3.34, 95%CI: 1.80-6.19 for obese pregnant women). There was no association between pregestational malnutrition and low birth weight (RR=1.70; 95%CI: 0.81-3.55). The present data showed a high rate of women with excess pregestational weight, supporting the hypothesis that pregestational BMI may contribute to high birth weight babies and indicating the need for actions aiming to prevent excessive weight in women at reproductive age.
Highlights
Birth weight is considered the main indicator of newborn health in both epidemiological studies and clinical practice given its strong association with morbidity-mortality at the beginning of life [1]
Excess pregestational weight increases the risk of high birth weight and large for gestational age (LGA) NB [9,11,12], which in turn is related to overweight and/or obesity during the life cycle [9,11]
Overweight was observed in 25.4% and obesity in 14.2% of pregnant women; 14% were adolescents, 49.3% were primiparous, 8.4% had a lower level of schooling, 28.4% had a diet rich in fat, 12.7% were smokers, 14% had gestational hypertension, 5.3% had gestational diabetes, 16.1% were sedentary, and 59.6% had a cesarean section (Table 1)
Summary
Birth weight is considered the main indicator of newborn health in both epidemiological studies and clinical practice given its strong association with morbidity-mortality at the beginning of life [1]. Several authors have considered factors such as pregestational maternal weight and height and maternal weight gain during pregnancy to be strongly associated with birth weight [5,6,7]. Studies have shown that pregestational maternal malnutrition may increase the risk of preterm birth, low birth weight, and small for gestational age (SGA) NB [8,9,10]. Excess pregestational weight increases the risk of high birth weight and large for gestational age (LGA) NB [9,11,12], which in turn is related to overweight and/or obesity during the life cycle [9,11]. Research on the association between an adverse environment from the beginning of life and the subsequent development of non-communicable diseases has allowed an understanding of the origin of some metabolic diseases, such as diabetes and obesity, certain types of cancer, and some
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