Neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: A prospective cohort study


Autoři: Marie Moreau aff001;  Mathilde Remy aff001;  Simon Nusinovici aff002;  Valérie Rouger aff003;  Lisa Molines aff001;  Cyril Flamant aff003;  Guillaume Legendre aff005;  Jean-Christophe Rozé aff003;  Agnès Salle aff006;  Patrick Van Bogaert aff003;  Régis Coutant aff008;  Géraldine Gascoin aff001
Působiště autorů: Department of Neonatal Medicine, Angers University Hospital, Angers, France aff001;  CIC 1413, Nantes University Hospital, Nantes, France aff002;  Loire Infant Follow-Up Team (LIFT) Network, Pays de Loire, France aff003;  Department of Neonatal Medicine, Nantes University Hospital, Nantes, France aff004;  Department of Obstetrics and Gynaecology, Angers University Hospital, Angers, France aff005;  Department of Endocrinology, Diabetology and Nutrition, Angers University Hospital, Angers, France aff006;  Department of Paediatric Neurology, Angers University Hospital, Angers, France aff007;  Department of Paediatric Endocrinology, Angers University Hospital, Angers, France aff008
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pone.0225027

Souhrn

Objective

Maternal obesity is associated with an increase in maternal, foetal and neonatal morbidity and mortality. The aim of our study was to evaluate the relationships between maternal pre-pregnancy body mass index and (1) neonatal outcome in preterm infants, and (2) neurodevelopmental outcome at 2 years of corrected age.

Method

We conducted a single-centre cohort study. Infants born between 24+0 and 33+6 weeks of gestation between January 2009 and December 2013, hospitalised in the neonatal intensive care unit of Angers University Hospital, and with available data regarding maternal pre-pregnancy body mass index were eligible. Three groups were defined according to maternal body mass index: normal (n = 418), overweight (n = 136) and obese (n = 89). The primary outcome was neurodevelopment at 2 years of corrected age. Children with a non-optimal neuromotor and/or psychomotor assessment and/or a sensory disability were regarded as having a “non-optimal neurodevelopmental outcome”. Neuromotor function was regarded as non-optimal when cerebral palsy was present or when the clinical examination revealed neurological signs of abnormal muscular tone. Psychomotor assessment was regarded as non-optimal if the revised Brunet-Lézine test was < 85 or when the overall score in the parental Ages and Stages Questionnaire (ASQ) was < 185. Finally, sensory disabilities such as blindness and children who required a hearing aid were taken into account. The secondary outcome was the composite criteria of neonatal complications. Multivariable analysis included the following variables: mother’s age, gestational age, smoking during pregnancy, magnesium sulphate and steroid treatment during pregnancy, twin status, gender, socioeconomic status and social security benefits for those with low incomes.

Results

The study population was composed of 643 preterm infants. Among them, 520 were assessed at 2 years. There was no difference in the proportion of infants with non-optimal neurodevelopmental outcomes between the three groups (16.6% for obese, 13.5% for overweight, 16.9% for normal body mass index mothers; p = 0.73). According to multivariable analysis, being born from an overweight or obese mother was not associated with an increased risk of non-optimal neuro-development at 2 years (adjusted OR = 0.84 [0.40–1.76] for obese, adjusted OR = 0.83 [0.43–1.59] for overweight mothers). There was no difference in the proportion of preterm infants with a non-optimal composite criterion of neonatal complications between the three groups. In the multivariable analysis, being born from an overweight or obese mother was not associated with an increased risk of non-optimal neonatal outcomes (adjusted OR = 0.95 [0.49–1.83] for obese, adjusted OR = 1.18 [0.69–2.01] for overweight mothers).

Conclusion

In this large prospective cohort of preterm infants born before 34 weeks of gestation, we found no relationship between maternal body mass index and neurodevelopmental outcomes at 2 years of corrected age and no relationship between maternal body mass index and neonatal outcomes. Other prematurity-related factors may be more relevant for neurodevelopmental outcome than the mother’s pre-pregnancy BMI.

Klíčová slova:

Birth weight – Body Mass Index – Cerebral palsy – Infants – Neonates – Neurodevelopment – Obesity – Pregnancy


Zdroje

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