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High Maternal Body Mass Index in Early Pregnancy and Risks of Stillbirth and Infant Mortality-A Population-Based Sibling Study in Sweden
Karolinska Inst, Stockholm, Sweden..
Karolinska Inst, Stockholm, Sweden.;Karolinska Inst, Soder Sjukhuset, Dept Clin Sci & Educ, Stockholm, Sweden..
Karolinska Inst, Stockholm, Sweden.;Univ Calif Berkeley, Sch Publ Hlth, Div Epidemiol, Berkeley, CA 94720 USA..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. Karolinska Inst, Stockholm, Sweden..
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2016 (English)In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 184, no 2, 98-105 p.Article in journal (Refereed) Published
Abstract [en]

In a population-based case-control study, we investigated whether familial confounding influenced the associations between maternal overweight/obesity and risks of stillbirth and infant mortality by including both population and sister controls. Using nationwide data from the Swedish Medical Birth Register (1992-2011), we included all primiparous women with singleton births who also had a sister with a first birth during that time period. We used logistic regression analyses to calculate odds ratios (and 95% confidence intervals) adjusted for maternal age, height, smoking habits, education, and time period (5-year groups) of child's birth. Body mass index (BMI) was calculated as weight (kg)/height (m)(2). Compared with population controls with a normal BMI (18.5-24.9), stillbirth risk increased with increasing BMI (BMI 25-29.9: odds ratio (OR) = 1.51 (95% confidence interval (CI): 1.21, 1.89); BMI 30-34.9: OR = 1.77 (95% CI: 1.24, 2.50); BMI a parts per thousand yen35: OR = 3.16 (95% CI: 2.10, 4.76)). The sister case-control analyses revealed similar results. Offspring of obese women (BMI a parts per thousand yen30) had an increased risk of infant mortality when population controls were used (OR = 2.41, 95% CI: 1.83, 3.16), and an even higher risk was obtained when sister controls were used (OR = 4.04, 95% CI: 2.25, 7.25). We conclude that obesity in early pregnancy is associated with increased risks of stillbirth and infant mortality independently of genetic and early environmental risk factors shared within families.

Place, publisher, year, edition, pages
2016. Vol. 184, no 2, 98-105 p.
Keyword [en]
body mass index, familial confounding, infant mortality, neonatal mortality, postneonatal mortality, sibling-design studies, stillbirth
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:uu:diva-305945DOI: 10.1093/aje/kww046ISI: 000383101500002PubMedID: 27358265OAI: diva2:1044530
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2016-11-03 Created: 2016-10-24 Last updated: 2016-11-03Bibliographically approved

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