Prepregnancy Obesity and Risks of Stillbirth
Publication Date
October 14, 2015
Journal
PLOS ONE
Authors
Suzan L. Carmichael, Yair J. Blumenfeld, Jonathan Mayo, Emily Wei, et al
Volume
10
Issue
10
Pages
e0138549
DOI
https://dx.plos.org/10.1371/journal.pone.0138549
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0138549
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/26466315
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605840
Europe PMC
http://europepmc.org/abstract/MED/26466315
Scopus
84949009036
Mendeley
http://www.mendeley.com/research/prepregnancy-obesity-risks-stillbirth
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Mendeley | Further Information

{"title"=>"Prepregnancy obesity and risks of stillbirth", "type"=>"journal", "authors"=>[{"first_name"=>"Suzan L.", "last_name"=>"Carmichael", "scopus_author_id"=>"7103352672"}, {"first_name"=>"Yair J.", "last_name"=>"Blumenfeld", "scopus_author_id"=>"25640750000"}, {"first_name"=>"Jonathan", "last_name"=>"Mayo", "scopus_author_id"=>"56075786600"}, {"first_name"=>"Emily", "last_name"=>"Wei", "scopus_author_id"=>"56988749600"}, {"first_name"=>"Jeffrey B.", "last_name"=>"Gould", "scopus_author_id"=>"7201688584"}, {"first_name"=>"David K.", "last_name"=>"Stevenson", "scopus_author_id"=>"7402384031"}, {"first_name"=>"Gary M.", "last_name"=>"Shaw", "scopus_author_id"=>"7401773618"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "pui"=>"607111569", "pmid"=>"26466315", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "doi"=>"10.1371/journal.pone.0138549", "sgr"=>"84949009036", "scopus"=>"2-s2.0-84949009036"}, "id"=>"9129de8c-e88c-3236-b73d-1627bddc2e47", "abstract"=>"BACKGROUND: We examined the association of maternal obesity with risk of stillbirth, focusing on whether the pattern of results varied by gestational age or maternal race-ethnicity or parity.\\n\\nMETHODS: Analyses included 4,012 stillbirths and 1,121,234 liveborn infants delivered in California from 2007-2010. We excluded stillbirths due to congenital anomalies, women with hypertensive disorders or diabetes, and plural births, to focus on fetuses and women without these known contributing conditions. We used Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CI). Separate models were run for stillbirths delivered at 20-23, 24-27, 28-31, 32-36, 37-41 weeks, relative to liveborn deliveries at 37-41 weeks.\\n\\nRESULTS: For stillbirth at 20-23 weeks, RRs were elevated for all race-ethnicity and parity groups. The RR for a 20-unit change in BMI (which reflects the approximate BMI difference between a normal weight and an Obese III woman) was 3.5 (95% CI 2.2, 5.6) for nulliparous white women and ranged from 1.8 to 5.0 for other sub-groups. At 24-27 weeks, the association was significant (p<0.05) only for multiparous non-Hispanic whites; at 28-31 weeks, for multiparous whites and nulliparous whites and blacks; at 32-36 weeks, for multiparous whites and nulliparous blacks; and at 37-41 weeks, for all groups except nulliparous blacks. The pattern of results was similar when restricted to stillbirths due to unknown causes and somewhat stronger when restricted to stillbirths attributable to obstetric causes.\\n\\nCONCLUSION: Increased risks were observed across all gestational ages, and some evidence of heterogeneity of the associations was observed by race-ethnicity and parity.", "link"=>"http://www.mendeley.com/research/prepregnancy-obesity-risks-stillbirth", "reader_count"=>32, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>5, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>5, "Student > Postgraduate"=>4, "Student > Master"=>6, "Other"=>1, "Student > Bachelor"=>4}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>5, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>5, "Student > Postgraduate"=>4, "Student > Master"=>6, "Other"=>1, "Student > Bachelor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Environmental Science"=>1, "Nursing and Health Professions"=>3, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>17, "Agricultural and Biological Sciences"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Chemistry"=>1, "Social Sciences"=>2, "Computer Science"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>17}, "Chemistry"=>{"Chemistry"=>1}, "Social Sciences"=>{"Social Sciences"=>2}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>3}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Norway"=>1, "United States"=>1}, "group_count"=>1}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2360070"], "description"=>"<p><sup>1</sup> p-values were <0.001 for Chi-square tests comparing each maternal characteristic among stillbirths versus liveborn term births.</p><p><sup>2</sup> This column represents term births that were included in analyses that excluded women with diabetes and hypertensive disorders. Gestational diabetes was not an exclusion criterion for models that included stillbirths delivered at 20–23 weeks; the number of term births for those comparison was 1,190,671.</p><p>Characteristics of stillbirths and liveborn term births included in analyses, California 2007–2010.<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138549#t001fn001\" target=\"_blank\"><sup>1</sup></a></p>", "links"=>[], "tags"=>["nulliparous blacks", "rr", "association", "Obese III woman", "bmi", "stillbirths", "obstetric causes.ConclusionIncreased risks", "multiparous whites", "ci"], "article_id"=>1575649, "categories"=>["Biological Sciences"], "users"=>["Suzan L. Carmichael", "Yair J. Blumenfeld", "Jonathan Mayo", "Emily Wei", "Jeffrey B. Gould", "David K. Stevenson", "Gary M. Shaw"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138549.t001", "stats"=>{"downloads"=>3, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_stillbirths_and_liveborn_term_births_included_in_analyses_California_2007_2010_1_/1575649", "title"=>"Characteristics of stillbirths and liveborn term births included in analyses, California 2007–2010.<sup>1</sup>", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360071"], "description"=>"<p><sup>1</sup> Relative Risks (RR) reflect estimated risk of stillbirth relative to term (37–41 weeks) live birth adjusted for maternal age, education, and height. Each 5-unit change in BMI reflects the approximate difference in risk between the following categories of BMI: a 5-unit change represents the approximate difference in risk between women with normal BMI (18.5–24.9 kg/m<sup>2</sup>, with 22.5 taken as the approximate mid-point) versus overweight (25.0–29.9 kg/m<sup>2</sup>, with 27.5 as the mid-point); a 10-unit change, the difference between women with normal BMI and obese class I (BMI 30.0–34.9 kg/m<sup>2</sup>, with 32.5 as the mid-point); a 15-unit change, the difference between normal BMI and obese class II (BMI 35.0–39.9 kg/m<sup>2</sup>, with 37.5 as mid-point); and a 20-unit change, the difference between normal BMI and obese class III (BMI ≥40.0 kg/m<sup>2</sup>, with 42.5 as reference). Analyses exclude women with gestational or pre-gestational diabetes or pregnancy-induced or chronic hypertension with one exception. For estimates among stillbirth at 20–23 weeks, the comparison group of term live births included the following additional births beyond those shown in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138549#pone.0138549.t001\" target=\"_blank\">Table 1</a> who had gestational diabetes: non-Hispanic White (n = 386,490), non-Hispanic Black (n = 69,633), and Hispanic (n = 734,548).</p><p><sup>2</sup> The quadratic term (BMI-squared) was significant (p<0.10) for the noted models; this is an indication that the association between BMI and risk of stillbirth was not linear, as reflected in the RRs for these groups, which are all relative to a BMI of 22.5 kg/m<sup>2</sup>.</p><p>Association of stillbirth with maternal pre-pregnancy body mass index specified as a continuous variable, by gestational age, race-ethnicity and parity, California 2007–2010.<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138549#t002fn001\" target=\"_blank\"><sup>1</sup></a></p>", "links"=>[], "tags"=>["nulliparous blacks", "rr", "association", "Obese III woman", "bmi", "stillbirths", "obstetric causes.ConclusionIncreased risks", "multiparous whites", "ci"], "article_id"=>1575650, "categories"=>["Biological Sciences"], "users"=>["Suzan L. Carmichael", "Yair J. Blumenfeld", "Jonathan Mayo", "Emily Wei", "Jeffrey B. Gould", "David K. Stevenson", "Gary M. Shaw"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138549.t002", "stats"=>{"downloads"=>3, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_of_stillbirth_with_maternal_pre_pregnancy_body_mass_index_specified_as_a_continuous_variable_by_gestational_age_race_ethnicity_and_parity_California_2007_2010_1_/1575650", "title"=>"Association of stillbirth with maternal pre-pregnancy body mass index specified as a continuous variable, by gestational age, race-ethnicity and parity, California 2007–2010.<sup>1</sup>", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360072"], "description"=>"<p><sup>1</sup> Relative Risks (RR) reflect estimated risk of stillbirth relative to term (37–41 weeks) live birth adjusted for maternal age, education, and height; excludes women with gestational or pre-gestational diabetes or pregnancy-induced or chronic hypertension with one exception. For estimates among stillbirth at 20–23 weeks, the comparison group of term live births included the following additional births beyond those shown in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138549#pone.0138549.t001\" target=\"_blank\">Table 1</a> who had gestational diabetes: non-Hispanic White (n = 386,490), non-Hispanic Black (n = 69,633), and Hispanic (n = 734,548). RRs were not calculated for cells with fewer than 3 cases.</p><p>Association of stillbirth with categories of maternal pre-pregnancy body mass index by gestational age, race-ethnicity and parity, California 2007–2010.<a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138549#t003fn001\" target=\"_blank\"><sup>1</sup></a></p>", "links"=>[], "tags"=>["nulliparous blacks", "rr", "association", "Obese III woman", "bmi", "stillbirths", "obstetric causes.ConclusionIncreased risks", "multiparous whites", "ci"], "article_id"=>1575651, "categories"=>["Biological Sciences"], "users"=>["Suzan L. Carmichael", "Yair J. Blumenfeld", "Jonathan Mayo", "Emily Wei", "Jeffrey B. Gould", "David K. Stevenson", "Gary M. Shaw"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138549.t003", "stats"=>{"downloads"=>5, "page_views"=>21, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_of_stillbirth_with_categories_of_maternal_pre_pregnancy_body_mass_index_by_gestational_age_race_ethnicity_and_parity_California_2007_2010_1_/1575651", "title"=>"Association of stillbirth with categories of maternal pre-pregnancy body mass index by gestational age, race-ethnicity and parity, California 2007–2010.<sup>1</sup>", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360073"], "description"=>"<p>Distribution of cause of death among stillbirths, by gestational age at delivery and maternal BMI (n = 4,012).</p>", "links"=>[], "tags"=>["nulliparous blacks", "rr", "association", "Obese III woman", "bmi", "stillbirths", "obstetric causes.ConclusionIncreased risks", "multiparous whites", "ci"], "article_id"=>1575652, "categories"=>["Biological Sciences"], "users"=>["Suzan L. Carmichael", "Yair J. Blumenfeld", "Jonathan Mayo", "Emily Wei", "Jeffrey B. Gould", "David K. Stevenson", "Gary M. Shaw"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138549.t004", "stats"=>{"downloads"=>2, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Distribution_of_cause_of_death_among_stillbirths_by_gestational_age_at_delivery_and_maternal_BMI_n_4_012_/1575652", "title"=>"Distribution of cause of death among stillbirths, by gestational age at delivery and maternal BMI (n = 4,012).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:55:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360074", "https://ndownloader.figshare.com/files/2360075"], "description"=>"<div><p>Background</p><p>We examined the association of maternal obesity with risk of stillbirth, focusing on whether the pattern of results varied by gestational age or maternal race-ethnicity or parity.</p><p>Methods</p><p>Analyses included 4,012 stillbirths and 1,121,234 liveborn infants delivered in California from 2007–2010. We excluded stillbirths due to congenital anomalies, women with hypertensive disorders or diabetes, and plural births, to focus on fetuses and women without these known contributing conditions. We used Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CI). Separate models were run for stillbirths delivered at 20–23, 24–27, 28–31, 32–36, 37–41 weeks, relative to liveborn deliveries at 37–41 weeks.</p><p>Results</p><p>For stillbirth at 20–23 weeks, RRs were elevated for all race-ethnicity and parity groups. The RR for a 20-unit change in BMI (which reflects the approximate BMI difference between a normal weight and an Obese III woman) was 3.5 (95% CI 2.2, 5.6) for nulliparous white women and ranged from 1.8 to 5.0 for other sub-groups. At 24–27 weeks, the association was significant (p<0.05) only for multiparous non-Hispanic whites; at 28–31 weeks, for multiparous whites and nulliparous whites and blacks; at 32–36 weeks, for multiparous whites and nulliparous blacks; and at 37–41 weeks, for all groups except nulliparous blacks. The pattern of results was similar when restricted to stillbirths due to unknown causes and somewhat stronger when restricted to stillbirths attributable to obstetric causes.</p><p>Conclusion</p><p>Increased risks were observed across all gestational ages, and some evidence of heterogeneity of the associations was observed by race-ethnicity and parity.</p></div>", "links"=>[], "tags"=>["nulliparous blacks", "rr", "association", "Obese III woman", "bmi", "stillbirths", "obstetric causes.ConclusionIncreased risks", "multiparous whites", "ci"], "article_id"=>1575653, "categories"=>["Biological Sciences"], "users"=>["Suzan L. Carmichael", "Yair J. Blumenfeld", "Jonathan Mayo", "Emily Wei", "Jeffrey B. Gould", "David K. Stevenson", "Gary M. Shaw"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0138549.s001", "https://dx.doi.org/10.1371/journal.pone.0138549.s002"], "stats"=>{"downloads"=>2, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prepregnancy_Obesity_and_Risks_of_Stillbirth_/1575653", "title"=>"Prepregnancy Obesity and Risks of Stillbirth", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-10-14 04:55:04"}

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{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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