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In-hospital mortality and morbidity among extremely preterm infants in relation to maternal body mass index

Journal of Perinatology volume 41, pages 1014–1024 (2021)Cite this article

Subjects

Abstract

Objective

The objective of this paper is to compare in-hospital survival and survival without major morbidities in extremely preterm infants in relation to maternal body mass index (BMI).

Methods

This retrospective cohort study included extremely preterm infants (gestational age 220/7–286/7 weeks). This study was conducted at National Institute of Child Health and Human Development Neonatal Research Network sites. Primary outcome was survival without any major morbidity.

Results

Maternal BMI data were available for 2415 infants. Survival without any major morbidity was not different between groups: 30.8% in the underweight/normal, 28.1% in the overweight, and 28.5% in the obese (P = 0.65). However, survival was lower in the obese group (76.5%) compared with overweight group (83.2%) (P = 0.02). Each unit increase in maternal BMI was associated with decreased odds of infant survival (P < 0.01).

Conclusions

Survival without any major morbidity was not associated with maternal obesity. An increase in maternal prepregnancy BMI was associated with decreased odds of infant survival.

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Fig. 1: Infant survival by maternal body mass index.
Fig. 2: Factors associated with survival to discharge without morbidities and survival to discharge.

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Funding

Supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA (UG1HD27904, UG1HD21364, U10HD68284, UG1HD27853, UL1TR77, UG1HD40492, UL1TR1117, UL1TR1111, UG1HD27851, UL1TR454, U10HD27856, UL1TR6, UG1HD87229, U10HD68278, U10 HD36790, UG1HD27880, UL1TR93, UG1 HD34216, U10HD68270, UG1HD53109, M01RR59, UL1TR442, UG1HD53089, UL1TR41, UG1HD68244, UG1HD68263, UL1TR42, UG1HD40689, UG1HD87226, UL1TR105, and U10HD21385).

Author information

Authors and Affiliations

  1. Department of Pediatrics, Wayne State University, Detroit, MI, USA

    Sanjay Chawla, Girija Natarajan & Seetha Shankaran

  2. Department of Pediatrics, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA

    Abbot R. Laptook

  3. RTI International, Washington, DC, USA

    Emily A. Smith & Sylvia Tan

  4. Department of Pediatrics, UT Southwestern Medical Center at Dallas, Dallas, TX, USA

    Myra H. Wyckoff

  5. Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA

    Namasivayam Ambalavanan

  6. Department of Pediatrics, University of Iowa, Iowa City, IA, USA

    Edward F. Bell

  7. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA

    Krisa P. Van Meurs

  8. Department of Pediatrics/Neonatology, Stanford University, Palo Alto, CA, USA

    David K. Stevenson

  9. Department of Obstetrics and Gynecology, Women and Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA

    Erika F. Werner

  10. Department of Pediatrics, Duke University, Durham, NC, USA

    Rachel G. Greenberg

  11. Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville, MD, USA

    Abhik Das

Authors
  1. Sanjay Chawla
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  2. Abbot R. Laptook
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  10. David K. Stevenson
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Consortia

for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network

Contributions

SC: developed the protocol, created data collection form, reviewed analysis, and drafted first version of the paper. ARL: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. EAS: reviewed the protocol, conducted the data analysis, and revised the paper critically. ST: reviewed the protocol, conducted the data analysis, and revised the paper critically. GN: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. MHW: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. NA: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. EFB: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. KPVM: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. DKS: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. EFW: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. RGG: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. AD: contributed to the conception and design, supervised the analysis, reviewed the protocol, and revised the paper critically. SS: contributed to the conception and design, reviewed the protocol, contributed to the analysis, and revised the paper critically. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Sanjay Chawla.

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The authors declare that they have no conflict of interest.

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Members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network are listed in Supplementary information.

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Chawla, S., Laptook, A.R., Smith, E.A. et al. In-hospital mortality and morbidity among extremely preterm infants in relation to maternal body mass index. J Perinatol 41, 1014–1024 (2021). https://doi.org/10.1038/s41372-020-00847-0

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