Integrating multiple lines of evidence to assess the effects of maternal BMI on pregnancy and perinatal outcomes

Mostra el registre complet Registre parcial de l'ítem

• dc.contributor.author Borges, Maria Carolina
• dc.contributor.author Bustamante Pineda, Mariona
• dc.contributor.author Vrijheid, Martine
• dc.contributor.author Lawlor, Deborah
• dc.date.accessioned 2024-06-25T06:14:23Z
• dc.date.available 2024-06-25T06:14:23Z
• dc.date.issued 2024
• dc.description.abstract Background: Higher maternal pre-pregnancy body mass index (BMI) is associated with adverse pregnancy and perinatal outcomes. However, whether these associations are causal remains unclear. Methods: We explored the relation of maternal pre-/early-pregnancy BMI with 20 pregnancy and perinatal outcomes by integrating evidence from three different approaches (i.e. multivariable regression, Mendelian randomisation, and paternal negative control analyses), including data from over 400,000 women. Results: All three analytical approaches supported associations of higher maternal BMI with lower odds of maternal anaemia, delivering a small-for-gestational-age baby and initiating breastfeeding, but higher odds of hypertensive disorders of pregnancy, gestational hypertension, preeclampsia, gestational diabetes, pre-labour membrane rupture, induction of labour, caesarean section, large-for-gestational age, high birthweight, low Apgar score at 1 min, and neonatal intensive care unit admission. For example, higher maternal BMI was associated with higher risk of gestational hypertension in multivariable regression (OR = 1.67; 95% CI = 1.63, 1.70 per standard unit in BMI) and Mendelian randomisation (OR = 1.59; 95% CI = 1.38, 1.83), which was not seen for paternal BMI (OR = 1.01; 95% CI = 0.98, 1.04). Findings did not support a relation between maternal BMI and perinatal depression. For other outcomes, evidence was inconclusive due to inconsistencies across the applied approaches or substantial imprecision in effect estimates from Mendelian randomisation. Conclusions: Our findings support a causal role for maternal pre-/early-pregnancy BMI on 14 out of 20 adverse pregnancy and perinatal outcomes. Pre-conception interventions to support women maintaining a healthy BMI may reduce the burden of obstetric and neonatal complications. Funding: Medical Research Council, British Heart Foundation, European Research Council, National Institutes of Health, National Institute for Health Research, Research Council of Norway, Wellcome Trust.
• dc.description.sponsorship This study was supported by the MRC Integrative Epidemiology Unit at the University of Bristol (MC_UU_00032/05), British Heart Foundation (AA/18/1/34219), the European Research Council under the European Union’s Seventh Framework Programme (FP/2007–2013)/ERC Grant Agreement (Grant number 669545), the European Union’s Horizon 2020 research and innovation programme under grant agreement No 733206 (LifeCycle), the US National Institutes of Health (R01 DK10324, U01 HG004415), the Bristol NIHR Biomedical Research Centre, and the Research Council of Norway through its Centres of Excellence funding scheme (project number 262700), and the Wellcome Trust [Grant number WT220390]. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author-Accepted Manuscript version arising from this submission. MCB has received support from MRC Skills Development Fellowship (MR/P014054/1) and the University of Bristol Vice-Chancellor’s Fellowship. DAL is a British Heart Foundation Chair (CH/F/20/90003) and NIHR Senior Investigator (NF-0616–10102). JT is supported by an Academy of Medical Sciences (AMS) Springboard Award, which is supported by the AMS, the Wellcome Trust, GCRF, the Government Department of Business, Energy and Industrial Strategy, the British Heart Foundation and Diabetes UK [SBF004\1079]. RMF was funded by a Wellcome Trust and Royal Society Sir Henry Dale Fellowship (WT104150) and is now funded by a Wellcome Trust Senior Research Fellowship (WT220390). RG received funding from the Dutch Heart Foundation (grant number 2017T013), the Dutch Diabetes Foundation (grant number 2017.81.002), and the Netherlands Organization for Health Research and Development (NWO, ZonMW, grant number 543003109). VWVJ received a Consolidator Grant from the European Research Council (ERC-2014-CoG-648916). XL received support from the Nordic Center of Excellence in Health-Related e-Sciences. LS reports funding from a Carlsberg Foundation postdoctoral fellowship (CF15-0899). BF was supported by an Oak Foundation Fellowship and by a grant from the Novo Nordisk Foundation (12,955). MCM has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement number 947684). TAB is supported by the Medical Research Council (MRC) (UK) (MR/K501281/1), the NHMRC (Australia) (GNT1183074 and GNT1157714), and the British Heart Foundation Accelerator Award at the University of Bristol (AA/18/1/34219) and works in/is affiliated with a unit that is supported by the UK Medical Research Council (MC_UU_00011/6). LB is a senior research scholar from the Fonds de la recherche du Québec-Santé (FRQ-S) and a member of the FRQ-S-funded Centre de recherche du CHUS. MFH was supported by an American Diabetes Association (ADA) Pathways Accelerator Award (1–15-ACE-26). SEH and MCM are partly funded by the Research Council of Norway (project no. 320656) and through its Centres of Excellence funding scheme (project No 262700). JW and RMc are supported by the National Institute for Health and Care Research under its Applied Research Collaboration, Yorkshire and Humber (NIHR200166).
• dc.format.mimetype application/pdf
• dc.identifier.citation Borges MC, Clayton GL, Freathy RM, Felix JF, Fernández-Sanlés A, Soares AG, et al. Integrating multiple lines of evidence to assess the effects of maternal BMI on pregnancy and perinatal outcomes. BMC Med. 2024 Jan 29;22(1):32. DOI: 10.1186/s12916-023-03167-0
• dc.identifier.doi http://dx.doi.org/10.1186/s12916-023-03167-0
• dc.identifier.issn 1741-7015
• dc.identifier.uri http://hdl.handle.net/10230/60584
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.relation.ispartof BMC Med. 2024 Jan 29;22(1):32
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/669545
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/733206
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/648916
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/947684
• dc.rights © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Body mass index
• dc.subject.keyword Mendelian randomisation
• dc.subject.keyword Pregnancy
• dc.subject.keyword Triangulation
• dc.title Integrating multiple lines of evidence to assess the effects of maternal BMI on pregnancy and perinatal outcomes
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion