ArticleBMC pregnancy and childbirth2022
Association of maternal obesity with preterm birth phenotype and mediation effects of gestational diabetes mellitus and preeclampsia: a prospective cohort study.
Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Correlation between TCF7L2 and CAPN10 gene polymorphisms and gestational diabetes mellitus in different geographical regions: a meta-analysis.BMC pregnancy and childbirth · 2024Pooled it
- Pooled it
- Association between pre-pregnancy BMI and preterm birth in Chinese women: a retrospective study.Annals of medicine · 2026Article
- [Causal Multiple Mediation Analysis of the Association Between Early and Mid-Pregnancy Body Mass Index Trajectories and Preterm Birth].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2026Article
- Beyond the Scale: Effects of Maternal Obesity on Embryo Morphokinetics and IVF Outcomes.Journal of clinical medicine · 2026Article
- Article
- Preterm Birth and Maternal Cardiovascular Risk.European cardiology · 2026Review
- Two Decades of Change: Evolving Maternal Characteristics and Perinatal Outcomes in Pregnant Women Living with HIV.Viruses · 2025Article
- Gestational Age and Cognitive Development in Childhood.JAMA network open · 2025Article
- The Role of Obesity in the Development of Preeclampsia.Current hypertension reports · 2024Review
- Risk of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus by age: a multicentric cohort study in Hebei, China.Scientific reports · 2024Article
- Construction and validation of a novel nomogram for predicting spontaneous preterm birth in patients with gestational diabetes mellitus.American journal of translational research · 2024Article
- Pre-pregnancy obesity is not associated with poor outcomes in fresh transfer in vitro fertilization cycles: a retrospective study.BMC pregnancy and childbirth · 2023Article
- Gestational Diabetes and Preterm Birth: What Do We Know? Our Experience and Mini-Review of the Literature.Journal of clinical medicine · 2023Article
- Maternal plasma and salivary anelloviruses in pregnancy and preterm birth.Frontiers in medicine · 2023Article
- Serum Proteomic Signatures in Umbilical Cord Blood of Preterm Neonates Delivered by Women with Gestational Diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between maternal obesity and preterm birth remains controversial and inconclusive, and the effects of gestational diabetes mellitus (GDM) and preeclampsia (PE) on the relationship between obesity and preterm birth have not been studied. We aimed to clarify the relationship between prepregnancy body mass index (BMI) and the phenotypes of preterm birth and evaluate the mediation effects of GDM and PE on the relationship between prepregnancy BMI and preterm birth.
methodsWe conducted a prospective cohort study of 43,056 women with live singleton births from 2017 through 2019. According to the WHO International Classification, BMI was classified as underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5-25 kg/m2), overweight (BMI 25-30 kg/m2) and obese (BMI ≥30 kg/m2). Preterm birth was defined as gestational age less than 37 weeks (extremely, < 28 weeks; very, 28-31 weeks; and moderately, 32-36 weeks). The clinical phenotypes of preterm birth included spontaneous preterm birth (spontaneous preterm labor and premature rupture of the membranes) and medically indicated preterm birth. We further analyzed preterm births with GDM or PE. Multivariable logistic regression analysis and causal mediation analysis were performed.
resultsRisks of extremely, very, and moderately preterm birth increased with BMI, and the highest risk was observed for obese women with extremely preterm birth (OR 3.43, 95% CI 1.07-10.97). Maternal obesity was significantly associated with spontaneous preterm labor (OR 1.98; 95% CI 1.13-3.47), premature rupture of the membranes (OR 2.04; 95% CI 1.08-3.86) and medically indicated preterm birth (OR 2.05; 95% CI 1.25-3.37). GDM and PE mediated 13.41 and 36.66% of the effect of obesity on preterm birth, respectively. GDM mediated 32.80% of the effect of obesity on spontaneous preterm labor and PE mediated 64.31% of the effect of obesity on medically indicated preterm birth.
conclusionsMaternal prepregnancy obesity was associated with all phenotypes of preterm birth, and the highest risks were extremely preterm birth and medically indicated preterm birth. GDM and PE partially mediated the association between obesity and preterm birth.
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