Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Pediatric Original Article
  • Published:

Maternal pregravid body mass index and child hospital admissions in the first 5 years of life: results from an Australian birth cohort

International Journal of Obesity volume 38, pages 1268–1274 (2014)Cite this article

Subjects

Abstract

Objectives:

To examine the association of maternal pregravid body mass index (BMI) and child offspring, all-cause hospitalisations in the first 5 years of life.

Methods:

Prospective birth cohort study. From 2006 to 2011, 2779 pregnant women (2807 children) were enrolled in the Environments for Healthy Living: Griffith birth cohort study in South-East Queensland, Australia. Hospital delivery record and self-report baseline survey of maternal, household and demographic factors during pregnancy were linked to the Queensland Hospital Admitted Patients Data Collection from 1 November 2006 to 30 June 2012, for child admissions. Maternal pregravid BMI was classified as underweight (<18.5 kg m−2), normal weight (18.5–24.9 kg m−2), overweight (25.0–29.9 kg m−2) or obese (⩾30 kg m−2). Main outcomes were the total number of child hospital admissions and ICD-10-AM diagnostic groupings in the first 5 years of life. Negative binomial regression models were calculated, adjusting for follow-up duration, demographic and health factors. The cohort comprised 8397.9 person years (PYs) follow-up.

Results:

Children of mothers who were classified as obese had an increased risk of all-cause hospital admissions in the first 5 years of life than the children of mothers with a normal BMI (adjusted rate ratio (RR) =1.48, 95% confidence interval 1.10–1.98). Conditions of the nervous system, infections, metabolic conditions, perinatal conditions, injuries and respiratory conditions were excessive, in both absolute and relative terms, for children of obese mothers, with RRs ranging from 1.3–4.0 (PYs adjusted). Children of mothers who were underweight were 1.8 times more likely to sustain an injury or poisoning than children of normal-weight mothers (PYs adjusted).

Conclusion:

Results suggest that if the intergenerational impact of maternal obesity (and similarly issues related to underweight) could be addressed, a significant reduction in child health care use, costs and public health burden would be likely.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2224–2260.

    Article  Google Scholar 

  2. World Health Organization. Global Status Report on Noncommunicable Diseases 2010. World Health Organization: Geneva, 2011.

  3. Kanter R, Caballero B . Global gender disparities in obesity: a review. Adv Nutr 2012; 3: 491–498.

    Article  Google Scholar 

  4. Keats S, Wiggins S . Future diets: implications for agriculture and food prices. Overseas Dev Inst 2014; http://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/8776.pdf.

  5. Haberg SE, Stigum H, London SJ, Nystad W, Nafstad P . Maternal obesity in pregnancy and respiratory health in early childhood. Paediatr Perinat Epidemiol 2009; 23: 352–362.

    Article  Google Scholar 

  6. Ruager-Martin R, Hyde MJ, Modi N . Maternal obesity and infant outcomes. Early Hum Dev 2010; 86: 715–722.

    Article  Google Scholar 

  7. Kalk P, Guthmann F, Krause K, Relle K, Godes M, Gossing G et al. Impact of maternal body mass index on neonatal outcome. Eur J Med Res 2009; 14: 216–222.

    Article  CAS  Google Scholar 

  8. Sebastian Manzanares G, Angel Santalla H, Irene Vico Z, Lopez Criado MS, Alicia Pineda L, Jose Luis Gallo V . Abnormal maternal body mass index and obstetric and neonatal outcome. J Matern Fetal Neonatal Med 2012; 25: 308–312.

    Article  Google Scholar 

  9. Scott-Pillai R, Spence D, Cardwell C, Hunter A, Holmes V . The impact of body mass index on maternal and neonatal outcomes: a retrospective study in a UK obstetric population, 2004-2011. BJOG 2013; 120: 932–939.

    Article  CAS  Google Scholar 

  10. Lawlor DA, Relton C, Sattar N, Nelson SM . Maternal adiposity—a determinant of perinatal and offspring outcomes? Nat Rev Endocrinol 2012; 8: 679–688.

    Article  Google Scholar 

  11. Marshall NE, Guild C, Cheng YW, Caughey AB, Halloran DR . The effect of maternal body mass index on perinatal outcomes in women with diabetes. Am J Perinatol 2014; 31: 249–256.

    PubMed  Google Scholar 

  12. Denison FC, Norwood P, Bhattacharya S, Duffy A, Mahmood T, Morris C et al. Association between maternal body mass index during pregnancy, short-term morbidity, and increased health service costs: a population-based study. BJOG 2014; 121: 72–81; discussion 82.

    Article  CAS  Google Scholar 

  13. Blomberg M . Maternal obesity, mode of delivery, and neonatal outcome. Obstet Gynecol 2013; 122: 50–55.

    Article  Google Scholar 

  14. Kaplan-Sturk R, Akerud H, Volgsten H, Hellstrom-Westas L, Wiberg-Itzel E . Outcome of deliveries in healthy but obese women: obesity and delivery outcome. BMC Res Notes 2013; 6: 50.

    Article  Google Scholar 

  15. Galtier-Dereure F, Boegner C, Bringer J . Obesity and pregnancy: complications and cost. Am J Clin Nutr 2000; 71: 1242S–1248SS.

    Article  CAS  Google Scholar 

  16. Minsart AF, Buekens P, De Spiegelaere M, Englert Y . Neonatal outcomes in obese mothers: a population-based analysis. BMC Pregnancy Childbirth 2013; 13: 36.

    Article  Google Scholar 

  17. Yu Z, Han S, Zhu J, Sun X, Ji C, Guo X . Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight/obesity: a systematic review and meta-analysis. PLoS One 2013; 8: e61627.

    Article  CAS  Google Scholar 

  18. Ovesen P, Rasmussen S, Kesmodel U . Effect of prepregnancy maternal overweight and obesity on pregnancy outcome. Obstet Gynecol 2011; 118: 305–312.

    Article  Google Scholar 

  19. O'Reilly JR, Reynolds RM . The risk of maternal obesity to the long-term health of the offspring. Clin Endocrinol (Oxf) 2013; 78: 9–16.

    Article  Google Scholar 

  20. Parsons EC, Patel K, Tran BT, Littman AJ . Maternal pre-gravid obesity and early childhood respiratory hospitalization: a population-based case-control study. Matern Child Health J 2013; 17: 1095–1102.

    Article  Google Scholar 

  21. Reynolds RM, Osmond C, Phillips DI, Godfrey KM . Maternal BMI, parity, and pregnancy weight gain: influences on offspring adiposity in young adulthood. J Clin Endocrinol Metab 2010; 95: 5365–5369.

    Article  CAS  Google Scholar 

  22. Patel SP, Rodriguez A, Little MP, Elliott P, Pekkanen J, Hartikainen AL et al. Associations between prepregnancy obesity and asthma symptoms in adolescents. J Epidemiol Community Health 2012; 66: 809–814.

    Article  Google Scholar 

  23. Tanne JH . Maternal obesity and diabetes are linked to children's autism and similar disorders. BMJ 2012; 344: e2768.

    Article  Google Scholar 

  24. Chen Q, Sjolander A, Langstrom N, Rodriguez A, Serlachius E, D'Onofrio BM et al. Maternal pre-pregnancy body mass index and offspring attention deficit hyperactivity disorder: a population-based cohort study using a sibling-comparison design. Int J Epidemiol 2014; 43: 83–90.

    Article  CAS  Google Scholar 

  25. Reynolds RM, Allan KM, Raja EA, Bhattacharya S, McNeill G, Hannaford PC et al. Maternal obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: follow-up of 1 323 275 person years. BMJ 2013; 347: f4539.

    Article  Google Scholar 

  26. Cameron CM, Scuffham PA, Spinks A, Scott R, Sipe N, Ng S et al. Environments for Healthy Living (EFHL) Griffith birth cohort study: background and methods. Matern Child Health J 2012; 16: 1896–1905.

    Article  Google Scholar 

  27. Nicholson JM, Sanson A . A new longitudinal study of the health and wellbeing of Australian children: how will it help? Med J Aust 2003; 178: 282–284.

    PubMed  Google Scholar 

  28. Lynch JW . Social epidemiology: some observations on the past, present and future. Australas Epidomol 2000; 7: 7–15.

    Google Scholar 

  29. Eriksson JG . Epidemiology, genes and the environment: lessons learned from the Helsinki Birth Cohort Study. J Intern Med 2007; 261: 418–425.

    Article  CAS  Google Scholar 

  30. Stettler N, Iotova V . Early growth patterns and long-term obesity risk. Curr Opin Clin Nutr Metab Care 2010; 13: 294–299.

    Article  Google Scholar 

  31. Alati R, Al Mamun A, O'Callaghan M, Najman JM, Williams GM . In utero and postnatal maternal smoking and asthma in adolescence. Epidemiology 2006; 17: 138–144.

    Article  Google Scholar 

  32. Herman DR, Taylor Baer M, Adams E, Cunningham-Sabo L, Duran N, Johnson DB et al. Life course perspective: evidence for the role of nutrition. Matern Child Health J 2014; 18: 450–461.

    Article  Google Scholar 

  33. World Health Organization. Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation. World Health Organization: Geneva, 2000.

  34. Australian Bureau of Statistics. Comsumer Price Index, Australia 2006-10.

  35. Australian Bureau of Statistics 2011. Household Income and Income Distribution, Australia, 2009-10.

  36. Roberts CL, Lancaster PA . Australian national birthweight percentiles by gestational age. Med J Aust 1999; 170: 114–118.

    Article  CAS  Google Scholar 

  37. Vuong QH . Likelihood ratio tests for model selection and non-nested hypotheses. Econometrica 1989; 57: 307–333.

    Article  Google Scholar 

  38. SAS Sample 42514 Tests for Comparing Nested and Nonnested Models (Program). SAS Institute Inc.: Cary, NC, USA. http://support.sas.com/kb/42/514.html.

  39. McCullagh P, Nelder JA . Generalized linear models. 2nd edn. Chapman and Hall, 1989.

    Book  Google Scholar 

  40. Gardner W, Mulvey EP, Shaw EC . Regression analyses of counts and rates: poisson, overdispersed Poisson, and negative binomial models. Psychol Bull 1995; 118: 392–404.

    Article  CAS  Google Scholar 

  41. Weinberg CR . Toward a clearer definition of confounding. Am J Epidemiol 1993; 137: 1–8.

    Article  CAS  Google Scholar 

  42. Vinayagam D, Chandraharan E . The adverse impact of maternal obesity on intrapartum and perinatal outcomes. ISRN Obstetr Gynecol 2012; 2012: 939762.

    Google Scholar 

  43. Lynch CM, Sexton DJ, Hession M, Morrison JJ . Obesity and mode of delivery in primigravid and multigravid women. Am J Perinatol 2008; 25: 163–167.

    Article  CAS  Google Scholar 

  44. Leddy MA, Power ML, Schulkin J . The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol 2008; 1: 170–178.

    PubMed  PubMed Central  Google Scholar 

  45. Petrou S, Mehta Z, Hockley C, Cook-Mozaffari P, Henderson J, Goldacre M . The impact of preterm birth on hospital inpatient admissions and costs during the first 5 years of life. Pediatrics 2003; 112: 1290–1297.

    Article  Google Scholar 

  46. Yuksel B, Greenough A . Birth weight and hospital readmission of infants born prematurely. Arch Pediatr Adolesc Med 1994; 148: 384–388.

    Article  CAS  Google Scholar 

  47. Soskolne EI, Schumacher R, Fyock C, Young ML, Schork A . The effect of early discharge and other factors on readmission rates of newborns. Arch Pediatr Adolesc Med 1996; 150: 373–379.

    Article  CAS  Google Scholar 

  48. Goer H, Romano A, Sakala C . Vaginal or Cesarean Birth: What Is at Stake for Women and Babies? 2012, New York, USA.

  49. Martens PJ, Derksen S, Gupta S . Predictors of hospital readmission of Manitoba newborns within six weeks postbirth discharge: a population-based study. Pediatrics 2004; 114: 708–713.

    Article  Google Scholar 

  50. Cameron CM, Scuffham PA, Shibl R, Ng S, Scott R, Spinks A et al. Environments For Healthy Living (EFHL) Griffith birth cohort study: characteristics of sample and profile of antenatal exposures. BMC Pub Health 2012; 12: 1080.

    Article  Google Scholar 

  51. Hinkle SN, Sharma AJ, Kim SY, Schieve LA . Maternal prepregnancy weight status and associations with children's development and disabilities at kindergarten. Int J Obes (Lond) 2013; 37: 1344–1351.

    Article  CAS  Google Scholar 

  52. Heslehurst N, Ells LJ, Simpson H, Batterham A, Wilkinson J, Summerbell CD . Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36,821 women over a 15-year period. BJOG 2007; 114: 187–194.

    Article  CAS  Google Scholar 

  53. Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD . A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989-2007. Int J Obes (Lond) 2010; 34: 420–428.

    Article  CAS  Google Scholar 

  54. Langley K, Thapar A . Commentary: Maternal pre-pregnancy BMI and offspring ADHD: a lesson in the importance of testing causal pathways. Int J Epidemiol 2014; 43: 91–93.

    Article  Google Scholar 

Download references

Acknowledgements

The research reported in this publication is part of the Griffith Study of Population Health: Environments for Healthy Living (EFHL) (Australian and New Zealand Clinical Trials Registry: ACTRN12610000931077). Core funding to support EFHL is provided by Griffith University. The EFHL project was conceived by RJM, CMC, Professor Judy Searle and Professor Ronan Lyons. We are thankful for the contributions of the Project Manager, Rani Scott, and the current and past Database Managers. We gratefully acknowledge the administrative staff, research staff and the hospital antenatal and birth suite midwives of the participating hospitals for their valuable contributions to the study, in addition to the expert advice provided by Research Investigators throughout the project. CMC was supported by a Public Health Fellowship (ID 428254) from the National Health and Medical Research Council (NHMRC) Australia.

Author Contributions

CMC originated the research, conducted the statistical analyses and led the writing of the article. APH contributed to the writing of literature review and discussion in the article. CMC and RJM originated the EFHL study and supervised all aspects of its implementation. All authors assisted with conceptualising ideas, interpreted research findings and contributed to the writing of the article. All authors read and approved the final manuscript.

Author information

Authors and Affiliations

  1. Centre of National Research on Disability and Rehabilitation, School of Human Services and Social Work, Griffith University, Griffith, Queensland, Australia

    C M Cameron

  2. Griffith Health Institute, Griffith University, Griffith, Queensland, Australia,

    C M Cameron, S-K Ng & A P Hills

  3. Faculty of Business, Queensland University of Technology, Brisbane, Queensland, Australia,

    R Shibl

  4. Monash Injury Research Institute, Monash University, Monash, Victoria, Australia

    R J McClure

  5. School of Medicine, Griffith University, Griffith, Queensland, Australia

    S-K Ng

  6. Mater Mothers’ Hospital, Mater Research Institute - University of Queensland, Brisbane, Queensland, Australia,

    A P Hills

Authors
  1. C M Cameron
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R Shibl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R J McClure
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S-K Ng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A P Hills
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C M Cameron.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cameron, C., Shibl, R., McClure, R. et al. Maternal pregravid body mass index and child hospital admissions in the first 5 years of life: results from an Australian birth cohort. Int J Obes 38, 1268–1274 (2014). https://doi.org/10.1038/ijo.2014.148

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2014.148

This article is cited by

Search

Advanced search

Quick links