PMID- 31395506
OWN - NLM
STAT- In-Data-Review
LR  - 20190823
IS  - 2213-8595 (Electronic)
IS  - 2213-8587 (Linking)
VI  - 7
IP  - 9
DP  - 2019 Sep
TI  - Association between maternal pre-pregnancy obesity and preterm birth according to
      maternal age and race or ethnicity: a population-based study.
PG  - 707-714
LID - S2213-8587(19)30193-7 [pii]
LID - 10.1016/S2213-8587(19)30193-7 [doi]
AB  - BACKGROUND: The relation between maternal pre-pregnancy obesity and preterm birth
      is controversial and inconclusive. We aimed to clarify the association between
      pre-pregnancy obesity and preterm birth by maternal age and race or ethnicity in 
      a large, multiracial, multiethnic, and diverse population in the USA. METHODS: We
      did a population-based cohort study using nationwide birth certificate data from 
      the US National Vital Statistics System for 2016 and 2017. We included all
      mothers who had a live singleton birth and who did not have pre-existing
      hypertension or diabetes. Pre-pregnancy obesity was defined as a pre-pregnancy
      BMI of at least 30 kg/m(2). Preterm birth was defined as gestational age of less 
      than 37 weeks. We used logistic regression models adjusted for maternal age, race
      or ethnicity, parity, education levels, smoking during pregnancy, previous
      history of preterm birth, marital status, infant sex, and timing of initiation of
      prenatal care to estimate the odds ratio (OR) of preterm birth. FINDINGS: We
      included 7 141 630 singleton livebirths in our analysis, 527 637 (7.4%) of which 
      were preterm births. 127 611 (7.5%) Hispanic mothers, 244 578 (6.6%) non-Hispanic
      white mothers, and 102 509 (10.4%) non-Hispanic black mothers had preterm births.
      In the overall population, maternal pre-pregnancy obesity was significantly
      associated with an increased risk of preterm birth compared with maternal
      pre-pregnancy healthy weight (ie, BMI of 18.5-24.9 kg/m(2); adjusted OR 1.18 [95%
      CI 1.18-1.19]). In non-Hispanic white women, maternal obesity was inversely
      associated with preterm birth among those younger than 20 years (adjusted OR 0.92
      [95% CI 0.88-0.97]), but positively associated with preterm birth among those
      aged 20 years or older (1.04 [1.01-1.06], 1.20 [1.18-1.23], 1.34 [1.31-1.37],
      1.40 [1.36-1.43], and 1.39 [1.31-1.46] among those aged 20-24 years, 25-29 years,
      30-34 years, 35-39 years, and >/=40 years, respectively). In Hispanic women,
      maternal obesity was not associated with preterm birth among those younger than
      20 years (0.98 [0.93-1.04]), but positively associated with preterm birth among
      those aged 20 years or older (1.06 [1.03-1.09], 1.21 [1.17-1.24], 1.32
      [1.28-1.36], 1.38 [1.33-1.43], and 1.30 [1.22-1.40] among those aged 20-24 years,
      25-29 years, 30-34 years, 35-39 years, and >/=40 years, respectively). In
      non-Hispanic black women, maternal obesity was inversely associated with preterm 
      birth among those younger than 30 years (0.76 [0.71-0.81] in those <20 years,
      0.83 [0.80-0.86] in those aged 20-24 years, and 0.98 [0.95-1.01] among those aged
      25-29 years), but positively associated with preterm birth among those aged 30
      years or older (1.15 [1.11-1.19], 1.26 [1.20-1.32], and 1.29 [1.18-1.42] among
      those aged 30-34 years, 35-39 years, and >/=40 years, respectively).
      INTERPRETATION: Maternal pre-pregnancy obesity is significantly associated with
      the risk of preterm birth in the general population, but the risk differs
      according to maternal age and race or ethnicity. Future investigation is
      warranted to understand the underlying mechanisms. FUNDING: US National
      Institutes of Health.
CI  - Copyright (c) 2019 Elsevier Ltd. All rights reserved.
FAU - Liu, Buyun
AU  - Liu B
AD  - Department of Epidemiology, College of Public Health, University of Iowa, Iowa
      City, IA, USA.
FAU - Xu, Guifeng
AU  - Xu G
AD  - Department of Epidemiology, College of Public Health, University of Iowa, Iowa
      City, IA, USA.
FAU - Sun, Yangbo
AU  - Sun Y
AD  - Department of Epidemiology, College of Public Health, University of Iowa, Iowa
      City, IA, USA.
FAU - Du, Yang
AU  - Du Y
AD  - Department of Epidemiology, College of Public Health, University of Iowa, Iowa
      City, IA, USA.
FAU - Gao, Rui
AU  - Gao R
AD  - Shenzhen Birth Cohort Study Center, Nanshan Maternity and Child Healthcare
      Hospital of Shenzhen, Shenzhen, China.
FAU - Snetselaar, Linda G
AU  - Snetselaar LG
AD  - Department of Epidemiology, College of Public Health, University of Iowa, Iowa
      City, IA, USA; Obesity Research and Education Initiative, University of Iowa,
      Iowa City, IA, USA.
FAU - Santillan, Mark K
AU  - Santillan MK
AD  - Department of Obstetrics & Gynecology, University of Iowa, Iowa City, IA, USA;
      The Center for Hypertension Research, University of Iowa, Iowa City, IA, USA.
FAU - Bao, Wei
AU  - Bao W
AD  - Department of Epidemiology, College of Public Health, University of Iowa, Iowa
      City, IA, USA; Obesity Research and Education Initiative, University of Iowa,
      Iowa City, IA, USA; Fraternal Order of Eagles Diabetes Research Center,
      University of Iowa, Iowa City, IA, USA. Electronic address: wei-bao@uiowa.edu.
LA  - eng
PT  - Journal Article
DEP - 20190805
PL  - England
TA  - Lancet Diabetes Endocrinol
JT  - The lancet. Diabetes & endocrinology
JID - 101618821
SB  - IM
EDAT- 2019/08/10 06:00
MHDA- 2019/08/10 06:00
CRDT- 2019/08/10 06:00
PHST- 2019/04/02 00:00 [received]
PHST- 2019/05/24 00:00 [revised]
PHST- 2019/05/28 00:00 [accepted]
PHST- 2019/08/10 06:00 [pubmed]
PHST- 2019/08/10 06:00 [medline]
PHST- 2019/08/10 06:00 [entrez]
AID - S2213-8587(19)30193-7 [pii]
AID - 10.1016/S2213-8587(19)30193-7 [doi]
PST - ppublish
SO  - Lancet Diabetes Endocrinol. 2019 Sep;7(9):707-714. doi:
      10.1016/S2213-8587(19)30193-7. Epub 2019 Aug 5.