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Maternal body mass index and risk of intraventricular hemorrhage in preterm infants

Vidya V Pai1, Suzan L Carmichael1, Peiyi Kan1

  • 1Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.

Pediatric Research
|April 7, 2018
PubMed

Insights

Maternal pre-pregnancy obesity increases the risk of intraventricular hemorrhage (IVH) in preterm infants. This association is significantly influenced by the gestational age at delivery, highlighting complex maternal factors in IVH development.

Area of Science:

  • Neonatal Medicine
  • Perinatal Epidemiology
  • Maternal Health

Background:

  • Intraventricular hemorrhage (IVH) in preterm infants is a significant concern.
  • Maternal pre-pregnancy obesity and underweight are linked to inflammatory states.
  • An inflammatory intrauterine environment is hypothesized to connect maternal weight status with IVH risk.

Purpose of the Study:

  • To investigate the association between pre-pregnancy maternal obesity and underweight and the risk of IVH in preterm infants.
  • To explore the role of the intrauterine inflammatory environment in this association.
  • To examine whether gestational age mediates the relationship between maternal BMI and IVH.

Main Methods:

  • Population-based study of infants born between 22 and 32 weeks' gestation (2007-2011).
  • Data sourced from vital statistics and the California Perinatal Quality Care Collaborative.
  • Statistical analysis adjusted for confounders to assess risk for any IVH and severe IVH.

Main Results:

  • Among 20,927 infants, 23% experienced any IVH and 7% had severe IVH.
  • Pre-pregnancy obesity was associated with an increased risk of any IVH (RR 1.14) and severe IVH (RR 1.25).
  • The direct effect of obesity on IVH was significant after controlling for inflammation but not after controlling for gestational age.

Conclusions:

  • Pre-pregnancy obesity is a risk factor for IVH in preterm infants.
  • The observed association between maternal obesity and IVH appears to be largely mediated by gestational age at delivery.
  • Understanding contributing maternal factors is crucial for the complex etiology of IVH.

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