Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

TLDR

Overweight and obesity among women of reproductive age are rising worldwide. This study aimed to identify risk factors and assess maternal, fetal, and childhood outcomes associated with maternal obesity and excessive gestational weight gain. Using a population‑based prospective cohort of 6,959 mothers in Rotterdam (2001–2005), the authors examined socio‑demographic, lifestyle, and genetic determinants and their associations with pregnancy outcomes. Maternal obesity was linked to lower education, lower income, multiparity, and the FTO risk allele, and increased risks of gestational hypertension, preeclampsia, gestational diabetes, cesarean delivery, large‑for‑gestational‑age infants, and childhood obesity; excessive gestational weight gain was associated with European ethnicity, nulliparity, higher energy intake, and smoking, but showed weaker, mainly first‑trimester, effects on adverse outcomes, indicating that obesity carries a greater risk than excess weight gain alone.

Abstract

Abstract Objective: The prevalence of overweight and obesity among women of reproductive age is increasing. We aimed to determine risk factors and maternal, fetal and childhood consequences of maternal obesity and excessive gestational weight gain. Design and Methods: The study was embedded in a population‐based prospective cohort study among 6959 mothers and their children. The study was based in Rotterdam, The Netherlands (2001–2005). Results: Maternal lower educational level, lower household income, multiparity, and FTO risk allel were associated with an increased risk of maternal obesity, whereas maternal European ethnicity, nulliparity, higher total energy intake, and smoking during pregnancy were associated with an increased risk of excessive gestational weight gain (all p‐values <0.05). As compared to normal weight, maternal obesity was associated with increased risks of gestational hypertension (OR 6.31 (95% CI 4.30, 9.26)), preeclampsia (OR (3.61, (95% CI 2.04, 6.39)), gestational diabetes (OR 6.28 (95%CI 3.01, 13.06)), caesarean delivery (OR 1.91 (95% CI 1.46, 2.50)), delivering large size for gestational age infants (OR 2.97 (95% CI 2.16, 4.08)), and childhood obesity (OR 5.02 (95% CI:2.97, 8.45)). Weaker associations of excessive gestational weight gain with maternal, fetal and childhood outcomes were observed, with the strongest effects for first trimester weight gain. Conclusions: Our study shows that maternal obesity and excessive weight gain during pregnancy are associated with socio‐demographic, lifestyle, and genetic factors and with increased risks of adverse maternal, fetal and childhood outcomes. As compared to prepregnancy overweight and obesity, excessive gestational weight gain has a limited influence on adverse pregnancy outcomes.