title: Risk of Pregnancy Complications in Relation to Maternal Prepregnancy Body Mass Index: Population-Based Study from Finland 2006-10.
abstract: BACKGROUND
  Overweight and obesity are well-known risk factors for several pregnancy-related complications, but the nature of the association between maternal adiposity and these complications has been less studied. The objective of the present study was to examine the shape and the magnitude of the association between maternal prepregnancy body mass index and the risk of gestational diabetes, pre-eclampsia of different severity, gestational hypertension, and obstetric cholestasis among Finnish primiparae women.
  
  
  METHODS
  Data on all primiparae women who delivered a singleton newborn in Finland between 2006 and 2010 were identified from the Finnish Medical Birth Register and the Finnish Hospital Discharge Register (n = 119 485). Associations were analysed using restricted cubic spline regression and logistic regression models.
  
  
  RESULTS
  There was a nonlinear dose-dependent association between body mass index and the risk of gestational diabetes, pre-eclampsia, and gestational hypertension, and the risk was increased already among normal weight primiparae women. However, in the presence of pre-existing hypertension or diabetes body mass index was not associated with the risk of pre-eclampsia.
  
  
  CONCLUSIONS
  Efforts to reduce prepregnancy overweight and obesity need to be intensified, and also, measures to better identify those normal weight women who are at increased risk of gestational diabetes, pre-eclampsia and gestational hypertension should be developed.
authors.affiliation: Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland.
authors.forename: Johanna
authors.initials: J
authors.lastname: Metsälä
authors.affiliation: Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland.
authors.forename: Beata
authors.initials: B
authors.lastname: Stach-Lempinen
authors.affiliation: Department of Information, National Institute for Health and Welfare, Helsinki, Finland.|Nordic School of Public Health, Gothenburg, Sweden.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.|Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland.|Folkhälsan Research Centre, Helsinki, Helsingfors Universitet, Helsinki, Finland.|Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Saila
authors.initials: S
authors.lastname: Koivusalo
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data*; D002780:Cholestasis, Intrahepatic / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D007231:Infant, Newborn; D016015:Logistic Models; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011256:Pregnancy Outcome; D037841:Pregnant People; D012307:Risk Factors
keywords: Body mass index; gestational diabetes; gestational hypertension; obstetric cholestasis; pre-eclampsia