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

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 a...

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Autores principales: Moreau, Marie, Remy, Mathilde, Nusinovici, Simon, Rouger, Valérie, Molines, Lisa, Flamant, Cyril, Legendre, Guillaume, Roze, Jean-Christophe, Salle, Agnès, Van Bogaert, Patrick, Coutant, Régis, Gascoin, Géraldine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6894768/
https://www.ncbi.nlm.nih.gov/pubmed/31805081
http://dx.doi.org/10.1371/journal.pone.0225027
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author Moreau, Marie
Remy, Mathilde
Nusinovici, Simon
Rouger, Valérie
Molines, Lisa
Flamant, Cyril
Legendre, Guillaume
Roze, Jean-Christophe
Salle, Agnès
Van Bogaert, Patrick
Coutant, Régis
Gascoin, Géraldine
author_facet Moreau, Marie
Remy, Mathilde
Nusinovici, Simon
Rouger, Valérie
Molines, Lisa
Flamant, Cyril
Legendre, Guillaume
Roze, Jean-Christophe
Salle, Agnès
Van Bogaert, Patrick
Coutant, Régis
Gascoin, Géraldine
author_sort Moreau, Marie
collection PubMed
description 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.
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spelling pubmed-68947682019-12-14 Neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: A prospective cohort study Moreau, Marie Remy, Mathilde Nusinovici, Simon Rouger, Valérie Molines, Lisa Flamant, Cyril Legendre, Guillaume Roze, Jean-Christophe Salle, Agnès Van Bogaert, Patrick Coutant, Régis Gascoin, Géraldine PLoS One Research Article 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. Public Library of Science 2019-12-05 /pmc/articles/PMC6894768/ /pubmed/31805081 http://dx.doi.org/10.1371/journal.pone.0225027 Text en © 2019 Moreau et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Moreau, Marie
Remy, Mathilde
Nusinovici, Simon
Rouger, Valérie
Molines, Lisa
Flamant, Cyril
Legendre, Guillaume
Roze, Jean-Christophe
Salle, Agnès
Van Bogaert, Patrick
Coutant, Régis
Gascoin, Géraldine
Neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: A prospective cohort study
title Neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: A prospective cohort study
title_full Neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: A prospective cohort study
title_fullStr Neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: A prospective cohort study
title_full_unstemmed Neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: A prospective cohort study
title_short Neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: A prospective cohort study
title_sort neonatal and neurodevelopmental outcomes in preterm infants according to maternal body mass index: a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6894768/
https://www.ncbi.nlm.nih.gov/pubmed/31805081
http://dx.doi.org/10.1371/journal.pone.0225027
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