Abstract
Study Objective
To evaluate the association between maternal body mass index and neonatal outcomes
in adolescents and to compare neonatal outcomes between overweight and obese adolescents
and obstetric low-risk adult women.
Design
Retrospective cohort study using data from the Swedish Medical Birth Register.
Setting
Sweden.
Participants
All 31,386 primiparous adolescents younger than 20 years of age and 178,844 “standard”
women, defined as normal weight, obstetric low-risk adult women who delivered between
1992 and 2013. The adolescents were categorized according to weight and height in
early pregnancy into body mass index groups according to the World Health Organization
classification. Logistic regression models were used.
Interventions and Main Outcome Measures
Neonatal outcomes in relation to maternal body mass index groups.
Results
In the adolescents, 6109/31,386 (19.5%) and 2287/31,386 (7.3%) were overweight and
obese, respectively. Compared with normal weight adolescents, overweight adolescents
had a lower risk of having small for gestational age neonates, and higher risks for
having neonates with macrosomia, and being large for gestational age and with Apgar
score less than 7 at 5 minutes. The obese adolescents had increased risk for having
neonates being large for gestational age (3.8% vs 1.3%; adjusted odds ratio [aOR],
2.97 [95% confidence interval (CI), 2.30-3.84]), with macrosomia (>4500 g) (4.6% vs
1.4%; aOR, 2.95 [95% CI, 2.33-3.73]), and with Apgar score less than 7 at 5 minutes
(2.2% vs 1.1%; aOR, 1.98 [95% CI, 1.43-2.76]) than normal weight adolescents. Compared
with the standard women, overweight and obese adolescents had overall more adverse
neonatal outcomes.
Conclusion
Overweight and obese adolescents had predominantly increased risks for adverse neonatal
outcomes compared with normal weight adolescents and standard women.
Key Words
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References
- Adolescent pregnancy fact sheet.(Available:)http://www.who.int/mediacentre/factsheets/fs364/enDate accessed: May 12, 2018
- Statistics on pregnancies, deliveries and newborn infants 2016.(Available:)http://www.socialstyrelsen.se/publikationer2018/2018-1-6Date accessed: May 12, 2018
- Deliveries among teenage women- with emphasis on incidence and mode of delivery: a Swedish national survey from 1973-2010.BMC Pregnancy Childbirth. 2013; 13: 204
- Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study.BMJ Open. 2014; 4: e005840
- Teenage pregnancies: obstetric characteristics and outcome.Eur J Obstet Gynecol Reprod Biol. 2008; 137: 165
- Impact of maternal body mass index on intrapartum and neonatal outcomes in Brisbane, Australia 2007 to 2013.Birth. 2016; 43: 358
- Maternal morbid obesity and the risk of adverse pregnancy outcome.Obstet Gynecol. 2004; 103: 219
- Maternal obesity, mode of delivery, and neonatal outcome.Obstet Gynecol. 2013; 122: 50
- Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults.Lancet. 2017; 390: 2627
- Obesity and overweight fact sheet.(Available:)http://www.who.int/mediacentre/factsheets/fs311/enDate accessed: May 12, 2018
- Trends in body mass index in Swedish adolescents between 2001 and 2007.Acta Paediatr. 2009; 98: 519
- Obstetric outcomes in overweight and obese adolescents.Am J Obstet Gynecol. 2006; 195: 851
- Obesity trends and perinatal outcomes in black and white teenagers.Am J Obstet Gynecol. 2012; 207 (492.e1)
- The effect of teenage maternal obesity on perinatal outcomes.Obstet Gynecol. 2009; 113: 300
- To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women.J Matern Fetal Neonatal Med. 2017; 30: 1574
- The Swedish Medical Birth Register: a summary of content and quality.(Available:)http://www.socialstyrelsen.se/SiteCollectionDocuments/2018-1-6-Kvalitetsdeklaration.pdfDate accessed: May 12, 2018
- Obesity: preventing and managing the global epidemic: report of a WHO consultation.(Available:)http://apps.who.int/iris/handle/10665/42330Date accessed: May 12, 2018
- Intrauterine growth curves based on ultrasonically estimated foetal weights.Acta Paediatr. 1996; 85: 843
- Establishing a standard definition for child overweight and obesity worldwide: international survey.BMJ. 2000; 320: 1240
- Macrosomic births in the United States: determinants, outcomes, and proposed grades of risk.Am J Obstet Gynecol. 2003; 188: 1372
- Birth weight and subsequent risk of type 2 diabetes: a meta-analysis.Am J Epidemiol. 2007; 165: 849
- The influence of birthweight and intrauterine environment on adiposity and fat distribution in later life.Int J Obes Relat Metab Disord. 2003; 27: 755
- Maternal obesity and neonatal Apgar scores.J Matern Fetal Neonatal Med. 2010; 23: 89
- Obstetric outcomes in adolescents related to body mass index and compared with low-risk adult women.J Womens Health. 2017; 26: 426
Article info
Publication history
Published online: November 16, 2018
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
