Related Experiment Videos
Maternal prepregnancy body mass index and risk of bronchopulmonary dysplasia
Suzan L Carmichael1, Peiyi Kan1, Jeffrey B Gould1
1Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
Insights
Maternal prepregnancy underweight and obesity are linked to increased risk of bronchopulmonary dysplasia (BPD) in preterm infants. These findings suggest BPD may originate in utero, influenced by maternal inflammation and BMI.
Area of Science:
- Neonatal Medicine
- Perinatal Epidemiology
- Maternal Health
Background:
- Bronchopulmonary dysplasia (BPD) is a significant complication in preterm infants.
- Maternal prepregnancy body mass index (BMI) may influence infant respiratory outcomes.
- Inflammation associated with obesity is a potential risk factor for BPD.
Purpose of the Study:
- To investigate the association between maternal prepregnancy BMI and the development of BPD in preterm infants.
- To explore whether maternal BMI extremes (underweight and obesity) impact BPD risk.
Main Methods:
- Retrospective cohort study using linked California perinatal and vital statistics data (2007-2011).
- Included preterm infants (<1,500g birthweight or 22-29 weeks gestational age).
- BPD defined as continuous oxygen use at 36 weeks postmenstrual age; adjusted for maternal and infant factors.
Main Results:
- Among 12,621 infants, 32% developed BPD.
- Maternal underweight (BMI <16.9) and severe obesity (BMI ≥40.0) were associated with increased BPD risk (OR 1.7 and 1.3, respectively).
- A nonlinear association between maternal BMI and BPD risk was observed in male infants and those born at 25-29 weeks gestation.
Conclusions:
- Both low and high maternal prepregnancy BMI are associated with an elevated risk of BPD in preterm infants.
- Findings suggest BPD is multifactorial, with potential prenatal origins linked to maternal inflammation and BMI.
- Maternal BMI is a modifiable factor that may influence neonatal respiratory health outcomes.
Abstract:
BackgroundWe examined the relationship between women's prepregnancy BMI and development of bronchopulmonary dysplasia (BPD) in their preterm offspring, hypothesizing that obesity-associated inflammation may increase risk.MethodsWe studied infants born in California between 2007 and 2011, using linked data from California Perinatal Quality Care Collaborative neonatal intensive care units, hospital discharge, and vital statistics. We included infants with birthweight <1,500 g or gestational age at birth of 22-29 weeks. BPD was defined as continuous supplemental oxygen use at 36 weeks' postmenstrual age.ResultsAmong 12,621 infants, 4,078 (32%) had BPD. After adjustment for maternal race/ethnicity, age, education, payer source, and infant sex, BMI status underweight I (BMI <16.9, odds ratio (OR) 1.7, 95% confidence interval (CI) 1.3-2.1) and obesity III (BMI ⩾40.0, OR 1.3, 95% CI 1.0-1.6) were associated with an increased risk of BPD. When considering maternal BMI as a continuous variable, a nonlinear association with BPD was observed for male infants and infants delivered at 25-29 weeks of gestational age, but not for other subgroups.ConclusionBoth high and low maternal BMI were associated with increased BPD risk. These findings support the notion that BPD is a multi-factorial disease that may sometimes have its origins in utero and be influenced by maternal inflammation.