Cause-Specific Stillbirth and Neonatal Death According to Prepregnancy Obesity and Early Gestational Weight Gain: A Study in the Danish National Birth Cohort

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Maternal obesity is associated with impaired fetal and neonatal survival, but underlying mechanisms are poorly understood. We examined how prepregnancy BMI and early gestational weight gain (GWG) were associated with cause-specific stillbirth and neonatal death. In 85,822 pregnancies in the Danish National Birth Cohort (1996-2002), we identified causes of death from medical records for 272 late stillbirths and 228 neonatal deaths. Prepregnancy BMI and early GWG derived from an early pregnancy interview and Cox regression were used to estimate associations with stillbirth or neonatal death as a combined outcome and nine specific cause-of-death categories. Compared to women with normal weight, risk of stillbirth or neonatal death was increased by 66% with overweight and 78% with obesity. Especially deaths due to placental dysfunction, umbilical cord complications, intrapartum events, and infections were increased in women with obesity. More stillbirths and neonatal deaths were observed in women with BMI < 25 and low GWG. Additionally, unexplained intrauterine death was increased with low GWG, while more early stillbirths were seen with both low and high GWG. In conclusion, causes of death that relate to vascular and metabolic disturbances were increased in women with obesity. Low early GWG in women of normal weight deserves more clinical attention.

Original languageEnglish
Article number1676
JournalNutrients
Volume13
Issue number5
Number of pages17
ISSN2072-6643
DOIs
Publication statusPublished - 2021

    Research areas

  • fetal death, stillbirth, neonatal death, pregnancy, obesity, body mass index, gestational weight gain, gestational weight loss, BODY-MASS INDEX, CLASSIFYING PERINATAL DEATH, HIGH-FAT DIET, MATERNAL OBESITY, INFANT-DEATH, FETAL-DEATH, EARLY-PREGNANCY, POSTTERM BIRTH, RISK, ASSOCIATION

ID: 273124879