title: Maternal prepregnancy body mass index and risk of bronchopulmonary dysplasia.
abstract: BackgroundWe examined the relationship between women's prepregnancy BMI and development of bronchopulmonary dysplasia (BPD) in their preterm offspring, hypothesizing that obesity-associated inflammation may increase risk.MethodsWe studied infants born in California between 2007 and 2011, using linked data from California Perinatal Quality Care Collaborative neonatal intensive care units, hospital discharge, and vital statistics. We included infants with birthweight <1,500 g or gestational age at birth of 22-29 weeks. BPD was defined as continuous supplemental oxygen use at 36 weeks' postmenstrual age.ResultsAmong 12,621 infants, 4,078 (32%) had BPD. After adjustment for maternal race/ethnicity, age, education, payer source, and infant sex, BMI status underweight I (BMI <16.9, odds ratio (OR) 1.7, 95% confidence interval (CI) 1.3-2.1) and obesity III (BMI ⩾40.0, OR 1.3, 95% CI 1.0-1.6) were associated with an increased risk of BPD. When considering maternal BMI as a continuous variable, a nonlinear association with BPD was observed for male infants and infants delivered at 25-29 weeks of gestational age, but not for other subgroups.ConclusionBoth high and low maternal BMI were associated with increased BPD risk. These findings support the notion that BPD is a multi-factorial disease that may sometimes have its origins in utero and be influenced by maternal inflammation.
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
authors.forename: Suzan L
authors.initials: SL
authors.lastname: Carmichael
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
authors.forename: Peiyi
authors.initials: P
authors.lastname: Kan
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Gould
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
authors.forename: David K
authors.initials: DK
authors.lastname: Stevenson
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Shaw
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
authors.forename: Henry C
authors.initials: HC
authors.lastname: Lee
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D001835:Body Weight; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D002140:California / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007249:Inflammation; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal; D008297:Male; D000068097:Maternal Health; D009765:Obesity / Q000150:complications*; D010100:Oxygen / Q000627:therapeutic use; D010351:Patient Discharge; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D010100:Oxygen