Maternal obesity and excess of fetal growth in pre-eclampsia

Authors

  • S Rasmussen,

    Corresponding author
    1. Department of Clinical Science, University of Bergen, Bergen, Norway
    2. Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
    • Correspondence: S Rasmussen, Department of Obstetrics and Gynaecology, Haukeland University Hospital, N-5021 Bergen, Norway.

      Email Svein.Rasmussen@mfr.uib.no

    Search for more papers by this author
  • LM Irgens,

    1. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
    Search for more papers by this author
  • J Espinoza

    1. Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, Houston, TX, USA
    Search for more papers by this author

  • Linked article: This article is commented on by Lisonkova S and Joseph KS, pp. 1358 in this issue.

Abstract

Objective

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.

Methods

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.

Results

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).

Conclusions

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.

Ancillary