Am J Perinatol 2017; 34(06): 563-567
DOI: 10.1055/s-0036-1594015
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association of Maternal Obesity with Child Cerebral Palsy or Death

Jessica A. McPherson
1   Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
,
Marcela C. Smid
2   Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
Sarah Smiley
3   Department of Obstetrics and Gynecology, University of California Davis Medical Center, Sacramento, California
,
David M. Stamilio
1   Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
› Author Affiliations
Further Information

Publication History

19 July 2016

07 October 2016

Publication Date:
17 November 2016 (online)

Abstract

Objective The primary aim of this study was to determine if there is an association between maternal obesity and cerebral palsy or death in children.

Study Design This is a retrospective cohort analysis of a randomized controlled clinical trial previously performed by the Maternal–Fetal Medicine Units Network. Women in the original trial were included if at high risk for preterm delivery. The present study included singletons enrolled in the original study with complete data. Obese and nonobese women were compared. A secondary analysis comparing class 3 obese or classes 1 to 2 obese women to nonobese women was performed. The primary outcome was a composite of cerebral palsy or perinatal death.

Results In this study, 1,261 nonobese, 339 obese, and 69 morbidly obese women were included. When adjusted for gestational age at delivery and magnesium exposure, there was no association between maternal obesity and child cerebral palsy or death. In the analysis using obesity severity categories, excess risk for adverse outcome appeared confined to the class 3 obese group.

Conclusion In women at high risk of delivering preterm, maternal obesity was not independently associated with child cerebral palsy or death. The association in unadjusted analysis appears to be mediated by preterm birth among obese patients.

 
  • References

  • 1 American College of Obstetricians and Gynecologists. ACOG committee opinion no. 549: obesity in pregnancy. Obstet Gynecol 2013; 121 (1) 213-217
  • 2 Crisham Janik MD, Newman TB, Cheng YW, Xing G, Gilbert WM, Wu YW. Maternal diagnosis of obesity and risk of cerebral palsy in the child. J Pediatr 2013; 163 (5) 1307-1312
  • 3 Bergehella V. Obstetric Evidence Based Guidelines, 2nd ed. New York, NY: Informa Healthcare; 2012
  • 4 Pan C, Deroche CB, Mann JR, McDermott S, Hardin JW. Is prepregnancy obesity associated with risk of cerebral palsy and epilepsy in children?. J Child Neurol 2014; 29 (12) NP196-NP201
  • 5 Centers for Disease Control and Prevention Available at: http://www.cdc.gove/ncbddd/cp/data.html . Retrieved January 24, 2016
  • 6 Christensen D, Van Naarden Braun K, Doernberg NS , et al. Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning - Autism and Developmental Disabilities Monitoring Network, USA, 2008. Dev Med Child Neurol 2014; 56 (1) 59-65
  • 7 Bax M, Goldstein M, Rosenbaum P , et al; Executive Committee for the Definition of Cerebral Palsy. Proposed definition and classification of cerebral palsy, April 2005. Dev Med Child Neurol 2005; 47 (8) 571-576
  • 8 Rouse DJ, Hirtz DG, Thom E , et al; Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network. A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy. N Engl J Med 2008; 359 (9) 895-905
  • 9 McPherson J, Smiley S, Stamilio D. Maternal obesity and neuroprotective magnesium sulfate. Am J Obstet Gynecol 2015; 213 (4) 582.e1-582.e6