Maternal obesity

Despite the substantial progress in maternal and child health over the past few decades; there remain concerns about stillbirth and neonatal and infant death; particularly in low- and middle-income countries. Approximately 2.7 million stillbirths and 3.6 million neonatal deaths occur each year worldwide, 98% of which are in low- and middle-income countries. As an upper-middle-income country; China has about 150,000 stillbirths and a similar number of neonatal deaths annually.

The maternal obesity

Accumulating evidence has suggested that maternal obesity may contribute to the high prevalence of such events. Meta-analyses have indicated that maternal obesity increases the risk of stillbirth by 107%  and infant death by 42%; even modest increases in maternal BMI could increase these risks. middle-income countries. Gaining more knowledge on the comprehensive effects of maternal obesity and underweight on adverse pregnancy outcomes is a public health priority.
Therefore, they conducted this prospective cohort analysis to examine the association of maternal obesity and underweight in early pregnancy with various adverse pregnancy outcomes among Chinese nulliparous women. To date, related studies have predominately drawn from high-income countries such as the United States; the United Kingdom, Sweden, Australia, and Denmark.

The risk profiles between low- and middle-income and high-income countries are likely different; in view of the differences in the patterns of lifestyles and prenatal health care and the existence of racial disparities. However, the studies from low- and middle-income countries have limited and have reported inconsistent findings. In particular, to the best of our knowledge, no study has simultaneously investigated the effects of maternal obesity on a spectrum of offspring mortality indicators.

The prenatal micronutrient

A prospective cohort analysis was performed among 18,481 Chinese nulliparous women, using data from a 2006 to 2009 trial of prenatal micronutrient supplementation. Obesity was defined as BMI ≥ 27.5 kg/m2. Interested outcomes included fetal loss (spontaneous abortion plus stillbirth), infant death, total mortality, and preterm and birth weight outcomes. Compared with normal weight, obesity was associated with total mortality (adjusted relative risks [ARR] 1.34; 95% CI: 1.03‐1.74).
Fetal loss (ARR 1.51; 95% CI: 1.15‐1.99) but not with infant death (ARR 0.53; 95% CI: 0.20‐1.46). Further analyses showed that obesity was particularly with spontaneous abortion (ARR 1.51; 95% CI: 1.13‐2.02) rather than stillbirth (ARR 1.52; 95% CI: 0.65‐3.57). Moreover, obesity was with preterm birth (ARR 1.59; 95% CI: 1.25‐2.02), macrosomia (ARR 3.71, 95% CI: 3.01‐4.59), and large for gestational age (ARR 2.93; 95% CI: 2.49‐3.47).
Maternal obesity in early pregnancy is with various adverse pregnancy outcomes in Chinese nulliparous women, suggesting the importance of an appropriate weight before and during pregnancy. Women who plan pregnancies and their prenatal care providers may wish to weigh these findings to decrease the related risks,” said senior author Dr. Jianmeng Liu, of the Peking University Health Science Center, in China.