@article{3105887,
    title = "Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts",
    author = "Santos, S. and Voerman, E. and Amiano, P. and Barros, H. and Beilin, L.J. and Bergström, A. and Charles, M.-A. and Chatzi, L. and Chevrier, C. and Chrousos, G.P. and Corpeleijn, E. and Costa, O. and Costet, N. and Crozier, S. and Devereux, G. and Doyon, M. and Eggesbø, M. and Fantini, M.P. and Farchi, S. and Forastiere, F. and Georgiu, V. and Godfrey, K.M. and Gori, D. and Grote, V. and Hanke, W. and Hertz-Picciotto, I. and Heude, B. and Hivert, M.-F. and Hryhorczuk, D. and Huang, R.-C. and Inskip, H. and Karvonen, A.M. and Kenny, L.C. and Koletzko, B. and Küpers, L.K. and Lagström, H. and Lehmann, I. and Magnus, P. and Majewska, R. and Mäkelä, J. and Manios, Y. and McAuliffe, F.M. and McDonald, S.W. and Mehegan, J. and Melén, E. and Mommers, M. and Morgen, C.S. and Moschonis, G. and Murray, D. and Ní Chaoimh, C. and Nohr, E.A. and Nybo Andersen, A.-M. and Oken, E. and Oostvogels, A.J.J.M. and Pac, A. and Papadopoulou, E. and Pekkanen, J. and Pizzi, C. and Polanska, K. and Porta, D. and Richiardi, L. and Rifas-Shiman, S.L. and Roeleveld, N. and Ronfani, L. and Santos, A.C. and Standl, M. and Stigum, H. and Stoltenberg, C. and Thiering, E. and Thijs, C. and Torrent, M. and Tough, S.C. and Trnovec, T. and Turner, S. and van Gelder, M.M.H.J. and van Rossem, L. and von Berg, A. and Vrijheid, M. and Vrijkotte, T.G.M. and West, J. and Wijga, A.H. and Wright, J. and Zvinchuk, O. and Sørensen, T.I.A. and Lawlor, D.A. and Gaillard, R. and Jaddoe, V.W.V.",
    journal = "BJOG: An International Journal of Obstetrics and Gynaecology",
    year = "2019",
    volume = "126",
    number = "8",
    pages = "984-995",
    publisher = "Wiley-Blackwell Publishing Ltd",
    issn = "1470-0328, 1471-0528",
    doi = "10.1111/1471-0528.15661",
    keywords = "adult;  Article;  Australian;  body mass;  childbirth;  cohort analysis;  disease association;  European;  female;  gestational weight gain;  high risk patient;  human;  large for gestational age;  major clinical study;  maternal hypertension;  North American;  population risk;  preeclampsia;  pregnancy complication;  pregnancy diabetes mellitus;  premature labor;  priority journal;  risk assessment;  small for date infant;  Australia;  birth weight;  complication;  Europe;  gestational age;  gestational weight gain;  meta analysis;  newborn;  North America;  obesity;  odds ratio;  physiology;  pregnancy;  pregnancy complication;  risk factor, Adult;  Australia;  Birth Weight;  Body Mass Index;  Cohort Studies;  Europe;  Female;  Gestational Age;  Gestational Weight Gain;  Humans;  Infant, Newborn;  North America;  Odds Ratio;  Overweight;  Pregnancy;  Pregnancy Complications;  Risk Factors",
    abstract = "Objective: To assess the separate and combined associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact. Design: Individual participant data meta-analysis of 39 cohorts. Setting: Europe, North America, and Oceania. Population: 265 270 births. Methods: Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used. Main outcome measures: Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth. Results: Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31– 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain. Conclusions: Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity. Tweetable abstract: Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications. © 2019 Royal College of Obstetricians and Gynaecologists"
}