Linked article: This article is commented on by Lisonkova S and Joseph KS, pp. 1358 in this issue.
Maternal obesity and excess of fetal growth in pre-eclampsia
Article first published online: 3 MAR 2014
© 2014 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 121, Issue 11, pages 1351–1358, October 2014
How to Cite
Maternal obesity and excess of fetal growth in pre-eclampsia. BJOG 2014;121:1351–1358., , .
- Issue published online: 23 SEP 2014
- Article first published online: 3 MAR 2014
- Manuscript Accepted: 12 NOV 2013
- body mass index;
- large for gestational age;
To assess whether the reported excess of large for gestational age (LGA) neonates in pre-eclamptic women delivering at term is attributable to maternal obesity.
Design, setting and population
Population-based observational study including 77 294 singleton pregnancies registered in the Medical Birth Registry of Norway between 2007 and 2010.
Comparison of birthweight percentiles and z-scores between women with and without pre-eclampsia.
Main outcome measures
Odds ratio (OR) of LGA and z-scores of birthweight in relation to pre-eclampsia.
Pre-eclamptic women delivering at term had increased risk of having LGA neonates. Unadjusted ORs with 95% confidence interval (95% CI) of LGA above the 90th and 95th birthweight centiles were 1.4, 95% CI 1.2–1.6 and 1.6, 95% CI 1.3–1.9, respectively. The excess of LGA persisted after including gestational diabetes and diabetes types 1 and 2 in a multivariate analysis (corresponding ORs 1.3, 95% CI 1.1–1.5 and 1.4, 95% CI 1.2–1.7), but disappeared after adjusting for maternal prepregnant body mass index (ORs 1.1, 95% CI 0.9–1.2 and 1.1, 95% CI 0.9–1.3).
This study suggests accelerated fetal growth in a subset of pre-eclamptic women delivering at term. The excess of LGA neonates is attributable to maternal obesity among pre-eclamptic women delivering at term. The maternal obesity epidemic may lead to an increased prevalence of both pre-eclampsia and LGA neonates among women delivering at term.