TY  - JOUR
AB  - 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.
AU  - Santos, S.*
AU  - Voerman, E.*
AU  - Amiano, P.*
AU  - Barros, H.*
AU  - Beilin, L.J.*
AU  - Bergström, A.*
AU  - Charles, M.A.*
AU  - Chatzi, L.*
AU  - Chévrier, C.*
AU  - Chrousos, G.P.*
AU  - Corpeleijn, E.*
AU  - Costa, O.*
AU  - Costet, N.*
AU  - Crozier, S.*
AU  - Devereux, G.*
AU  - Doyon, M.*
AU  - Eggesbø, M.*
AU  - Fantini, M.P.*
AU  - Farchi, S.*
AU  - Forastiere, F.*
AU  - Georgiu, V.*
AU  - Godfrey, K.M.*
AU  - Gori, D.*
AU  - Grote, V.*
AU  - Hanke, W.*
AU  - Hertz-Picciotto, I.*
AU  - Heude, B.*
AU  - Hivert, M.F.*
AU  - Hryhorczuk, D.*
AU  - Huang, R.C.*
AU  - Inskip, H.*
AU  - Karvonen, A.M.*
AU  - Kenny, L.C.*
AU  - Koletzko, B.*
AU  - Küpers, L.K.*
AU  - Lagström, H.*
AU  - Lehmann, I.*
AU  - Magnus, P.*
AU  - Majewska, R.*
AU  - Mäkelä, J.*
AU  - Manios, Y.*
AU  - McAuliffe, F.M.*
AU  - McDonald, S.W.*
AU  - Mehegan, J.*
AU  - Melén, E.*
AU  - Mommers, M.*
AU  - Morgen, C.S.*
AU  - Moschonis, G.*
AU  - Murray, D.*
AU  - Chaoimh, C.N.*
AU  - Nohr, E.A.*
AU  - Nybo Andersen, A.M.*
AU  - Oken, E.*
AU  - Oostvogels, A.J.J.M.*
AU  - Pac, A.*
AU  - Papadopoulou, E.*
AU  - Pekkanen, J.*
AU  - Pizzi, C.*
AU  - Polanska, K.*
AU  - Porta, D.*
AU  - Richiardi, L.*
AU  - Rifas-Shiman, S.L.*
AU  - Roeleveld, N.*
AU  - Ronfani, L.*
AU  - Santos, A.C.*
AU  - Standl, M.
AU  - Stigum, H.*
AU  - Stoltenberg, C.*
AU  - Thiering, E.
AU  - Thijs, C.*
AU  - Torrent, M.*
AU  - Tough, S.C.*
AU  - Trnovec, T.*
AU  - Turner, S.*
AU  - van Gelder, M.M.H.J.*
AU  - van Rossem, L.*
AU  - von Berg, A.*
AU  - Vrijheid, M.*
AU  - Vrijkotte, T.G.M.*
AU  - West, J.*
AU  - Wijga, A.H.*
AU  - Wright, J.*
AU  - Zvinchuk, O.*
AU  - Sørensen, T.I.A.*
AU  - Lawlor, D.A.*
AU  - Gaillard, R.*
AU  - Jaddoe, V.W.V.*
C1  - 55540
C2  - 46379
CY  - 111 River St, Hoboken 07030-5774, Nj Usa
SP  - 984-995
TI  - 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.
JO  - BJOG
VL  - 126
IS  - 8
PB  - Wiley
PY  - 2019
SN  - 0022-3204
ER  - 

TY  - JOUR
AB  - Objective: Gestational diabetes mellitus (GDM) potentially harms the child before birth. We previously found GDM to be associated with developmental changes in the central nervous system. We now hypothesise that GDM may also impact on the fetal autonomic nervous system under metabolic stress like an oral glucose tolerance test (OGTT). Design: We measured heart rate variability (HRV) of mothers and fetuses during a three-point OGTT using fetal magnetocardiography (fMCG). Setting: Measurements were performed in the fMEG Centre in Tübingen. Population: After exclusion of 23 participants, 13 pregnant women with GDM and 36 pregnant women with normal glucose tolerance were examined. Methods: All women underwent the same examination setting with OGTT during which fMCG was recorded three times. Main outcome measure(s): Parameters of heart rate variability were measured. Results: Compared with mothers with normal glucose regulation, mothers with GDM showed increased heart rate but no significant differences of maternal HRV. In contrast, HRV in fetuses of mothers with GDM differed from those in the metabolically healthy group regarding standard deviation normal to normal beat (SDNN) (P = 0.012), low-frequency band (P = 0.008) and high-frequency band (P = 0.031). These HRV parameters exhibit a decrease only in GDM fetuses during the second hour of the OGTT. Conclusions: These results show an altered response of the fetal autonomic nervous system to metabolic stress in GDM-complicated pregnancies. Hence, disturbances in maternal glucose metabolism might not only impact on the central nervous system of the fetus but may also affect the fetal autonomic nervous system. Tweetable abstract: Metabolic stress reveals a different response of fetal autonomic nervous system in GDM-complicated pregnancies.
AU  - Fehlert, E.
AU  - Willmann, K.*
AU  - Fritsche, L.
AU  - Linder, K.
AU  - Mat-Husin, H.*
AU  - Schleger, F.
AU  - Weiss, M.*
AU  - Kiefer-Schmidt, I.*
AU  - Brucker, S.*
AU  - Häring, H.-U.
AU  - Preissl, H.
AU  - Fritsche, A.
C1  - 52227
C2  - 43816
SP  - 1891-1898
TI  - Gestational diabetes alters the fetal heart rate variability during an oral glucose tolerance test: a fetal magnetocardiography study.
JO  - BJOG
VL  - 124
IS  - 12
PY  - 2017
SN  - 0022-3204
ER  -