Maternal prepregnancy overweight/obesity increase the risk of low Apgar scores in twins: a population-based cohort study in China
ObjectiveWhile prepregnancy overweight or obesity is known to negatively impact maternal health, its effect on twin infants is not well understood. Therefore, we conducted a nationwide, multicenter retrospective study to investigate the association between maternal prepregnancy weight and health out...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2024.1412975/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841525899776753664 |
|---|---|
| author | Zhoushan Feng Zhoushan Feng Xiaohong Wu Xiaomei Tong Zheng He Chunxia Yang Wei Shen Yueqin Ding Jin Liu Qiong Meng Aiqin Zhang Hong Jiang Wenkang Yan Jianwu Qiu Xian Wei Yayu Zhang Xiaobo Lin Lijun Liu Ya Jin Youfen Wei Xiufang Yang Yitong Wang Yangfan Cai Xinzhu Lin Qiliang Cui |
| author_facet | Zhoushan Feng Zhoushan Feng Xiaohong Wu Xiaomei Tong Zheng He Chunxia Yang Wei Shen Yueqin Ding Jin Liu Qiong Meng Aiqin Zhang Hong Jiang Wenkang Yan Jianwu Qiu Xian Wei Yayu Zhang Xiaobo Lin Lijun Liu Ya Jin Youfen Wei Xiufang Yang Yitong Wang Yangfan Cai Xinzhu Lin Qiliang Cui |
| author_sort | Zhoushan Feng |
| collection | DOAJ |
| description | ObjectiveWhile prepregnancy overweight or obesity is known to negatively impact maternal health, its effect on twin infants is not well understood. Therefore, we conducted a nationwide, multicenter retrospective study to investigate the association between maternal prepregnancy weight and health outcomes in twins.Study designThis study collected data from 22 healthcare units across 12 regions in China between January 2018 and December 2020. To control for confounding factors, multiple logistic regression, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and overlapping weighting models (OW) were applied to explore the effects of prepregnancy BMI on Apgar scores and other outcomes.ResultsAfter screening, a total of 4,724 women with twin pregnancies and 9,448 newborns were included in the study. Compared to normal prepregnancy weight, prepregnancy overweight/obesity significantly increased the risk of gestational hypertension and gestational diabetes in mothers [adjusted OR (95% CI): 1.85 (1.55–2.21) and 1.49 (1.27–1.74), respectively]. It also increased the incidence of twins with a 1-min Apgar score ≤7, whether they were larger or smaller [1.60 (1.20–2.13) and 1.45 (1.09–1.92), respectively]. Sensitivity analyses using PSM [1.60 (1.20–2.13) and 1.55 (1.07–2.25)], IPTW [1.67 (1.31–2.12) and 1.48 (1.17–1.87)], and OW [1.65 (1.08–2.57) and 1.47 (0.97–2.25)] confirmed the stability of these results. However, it did not affect the likelihood of a 5-min Apgar score ≤7 [adjusted OR (95% CI): 0.82 (0.24–2.17) and 1.40 (0.70–2.73)]. In contrast, prepregnancy underweight was associated with a reduced incidence of twins with a 1-min Apgar score ≤7 [adjusted OR (95% CI): 0.56 (0.32–0.92) and 0.58 (0.34–0.94)], but had no effect on the 5-min Apgar score ≤7 [adjusted OR (95% CI): 0.82 (0.24–2.17) and 0.22 (0.01–1.08)]. Prepregnancy BMI did not significantly affect twin birth weight discordance, NICU admission, preterm birth, or low birth weight.ConclusionMaternal overweight/obesity before pregnancy increases the risk of hypertensive disorders and gestational diabetes in twin pregnancies and significantly raises the likelihood of twins having a low 1-min Apgar score. However, no significant impact on 5-min Apgar scores was observed. These findings highlight the importance of managing weight before pregnancy and ensuring readiness for neonatal resuscitation during delivery. |
| format | Article |
| id | doaj-art-fa6bebf42a7046e29aa0b7dc64258d87 |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-fa6bebf42a7046e29aa0b7dc64258d872025-01-17T06:51:01ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011210.3389/fped.2024.14129751412975Maternal prepregnancy overweight/obesity increase the risk of low Apgar scores in twins: a population-based cohort study in ChinaZhoushan Feng0Zhoushan Feng1Xiaohong Wu2Xiaomei Tong3Zheng He4Chunxia Yang5Wei Shen6Yueqin Ding7Jin Liu8Qiong Meng9Aiqin Zhang10Hong Jiang11Wenkang Yan12Jianwu Qiu13Xian Wei14Yayu Zhang15Xiaobo Lin16Lijun Liu17Ya Jin18Youfen Wei19Xiufang Yang20Yitong Wang21Yangfan Cai22Xinzhu Lin23Qiliang Cui24Department of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Obstetrics and Gynecology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Pediatrics, Peking University Third Hospital, Beijing, ChinaDepartment of Neonatology, Sichuan Jinxin Xinan Women & Children’s Hospital, Chengdu, ChinaDepartment of Neonatology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, ChinaDepartment of Neonatology, Xiamen Maternal and Child Health Care Hospital, Xiamen, ChinaDepartment of Neonatology, Affiliated Dongguan Shilong People’s Hospital of Southern Medical University, Dongguan, Guangdong, ChinaDepartment of Neonatology, First Affiliated Hospital of Shaoyang University, Shaoyang, ChinaDepartment of Neonatology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China0Department of Neonatology, Cangzhou People’s Hospital, Cangzhou, Hebei, China1Department of Neonatology, Affiliated Hospital of Yanan University, Yan an, China2Department of Neonatology, Huizhou Central People’s Hospital, Huizhou, China3Department of Neonatology, The Affiliated Yue Bei People’s Hospital of Shantou University Medical College, Shaoguan, China4Department of Neonatology, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Xiaogan, China5Department of Neonatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China6Department of Neonatology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China7Department of Neonatology, The Third Staff Hospital of Baogang Group Baotou, Baotou, China8Department of Neonatology and Pediatrics, Jinan University First Affiliated Hospital, Guangzhou, China9Department of Neonatology, Lanzhou University Second Hospital, Lanzhou, China0Department of Neonatology, Zhongshan City People’s Hospital, Zhongshan, China1Department of Neonatology, Binhaiwan Central Hospital of Dongguan, Dongguan, China2Department of Neonatology, The First Affiliated Hospital of Shantou University Medical College, Shantou, ChinaDepartment of Neonatology, Xiamen Maternal and Child Health Care Hospital, Xiamen, ChinaDepartment of Neonatology, Guangzhou Key Laboratory of Neonatal Intestinal Diseases, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaObjectiveWhile prepregnancy overweight or obesity is known to negatively impact maternal health, its effect on twin infants is not well understood. Therefore, we conducted a nationwide, multicenter retrospective study to investigate the association between maternal prepregnancy weight and health outcomes in twins.Study designThis study collected data from 22 healthcare units across 12 regions in China between January 2018 and December 2020. To control for confounding factors, multiple logistic regression, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and overlapping weighting models (OW) were applied to explore the effects of prepregnancy BMI on Apgar scores and other outcomes.ResultsAfter screening, a total of 4,724 women with twin pregnancies and 9,448 newborns were included in the study. Compared to normal prepregnancy weight, prepregnancy overweight/obesity significantly increased the risk of gestational hypertension and gestational diabetes in mothers [adjusted OR (95% CI): 1.85 (1.55–2.21) and 1.49 (1.27–1.74), respectively]. It also increased the incidence of twins with a 1-min Apgar score ≤7, whether they were larger or smaller [1.60 (1.20–2.13) and 1.45 (1.09–1.92), respectively]. Sensitivity analyses using PSM [1.60 (1.20–2.13) and 1.55 (1.07–2.25)], IPTW [1.67 (1.31–2.12) and 1.48 (1.17–1.87)], and OW [1.65 (1.08–2.57) and 1.47 (0.97–2.25)] confirmed the stability of these results. However, it did not affect the likelihood of a 5-min Apgar score ≤7 [adjusted OR (95% CI): 0.82 (0.24–2.17) and 1.40 (0.70–2.73)]. In contrast, prepregnancy underweight was associated with a reduced incidence of twins with a 1-min Apgar score ≤7 [adjusted OR (95% CI): 0.56 (0.32–0.92) and 0.58 (0.34–0.94)], but had no effect on the 5-min Apgar score ≤7 [adjusted OR (95% CI): 0.82 (0.24–2.17) and 0.22 (0.01–1.08)]. Prepregnancy BMI did not significantly affect twin birth weight discordance, NICU admission, preterm birth, or low birth weight.ConclusionMaternal overweight/obesity before pregnancy increases the risk of hypertensive disorders and gestational diabetes in twin pregnancies and significantly raises the likelihood of twins having a low 1-min Apgar score. However, no significant impact on 5-min Apgar scores was observed. These findings highlight the importance of managing weight before pregnancy and ensuring readiness for neonatal resuscitation during delivery.https://www.frontiersin.org/articles/10.3389/fped.2024.1412975/fullpregnancytwinsApgar scoreoverweightneonatology |
| spellingShingle | Zhoushan Feng Zhoushan Feng Xiaohong Wu Xiaomei Tong Zheng He Chunxia Yang Wei Shen Yueqin Ding Jin Liu Qiong Meng Aiqin Zhang Hong Jiang Wenkang Yan Jianwu Qiu Xian Wei Yayu Zhang Xiaobo Lin Lijun Liu Ya Jin Youfen Wei Xiufang Yang Yitong Wang Yangfan Cai Xinzhu Lin Qiliang Cui Maternal prepregnancy overweight/obesity increase the risk of low Apgar scores in twins: a population-based cohort study in China Frontiers in Pediatrics pregnancy twins Apgar score overweight neonatology |
| title | Maternal prepregnancy overweight/obesity increase the risk of low Apgar scores in twins: a population-based cohort study in China |
| title_full | Maternal prepregnancy overweight/obesity increase the risk of low Apgar scores in twins: a population-based cohort study in China |
| title_fullStr | Maternal prepregnancy overweight/obesity increase the risk of low Apgar scores in twins: a population-based cohort study in China |
| title_full_unstemmed | Maternal prepregnancy overweight/obesity increase the risk of low Apgar scores in twins: a population-based cohort study in China |
| title_short | Maternal prepregnancy overweight/obesity increase the risk of low Apgar scores in twins: a population-based cohort study in China |
| title_sort | maternal prepregnancy overweight obesity increase the risk of low apgar scores in twins a population based cohort study in china |
| topic | pregnancy twins Apgar score overweight neonatology |
| url | https://www.frontiersin.org/articles/10.3389/fped.2024.1412975/full |
| work_keys_str_mv | AT zhoushanfeng maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT zhoushanfeng maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT xiaohongwu maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT xiaomeitong maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT zhenghe maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT chunxiayang maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT weishen maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT yueqinding maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT jinliu maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT qiongmeng maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT aiqinzhang maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT hongjiang maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT wenkangyan maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT jianwuqiu maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT xianwei maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT yayuzhang maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT xiaobolin maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT lijunliu maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT yajin maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT youfenwei maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT xiufangyang maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT yitongwang maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT yangfancai maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT xinzhulin maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina AT qiliangcui maternalprepregnancyoverweightobesityincreasetheriskoflowapgarscoresintwinsapopulationbasedcohortstudyinchina |