Child Neurodevelopmental Outcomes by Prepregnancy Body Mass Index and Gestational Weight Gain

Michelle Kominiarek*, Marcela C. Smid, Lisa Mele, Brian M. Casey, Yoram Sorokin, Uma M. Reddy, Ronald J. Wapner, John M. Thorp, George R. Saade, Alan T.N. Tita, Dwight J. Rouse, Baha Sibai, Jay D. Iams, Brian M. Mercer, Jorge Tolosa, Steve N. Caritis

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:To study the association of prepregnancy body mass index (BMI) and gestational weight gain with child neurodevelopmental outcomes.METHODS:We performed a secondary analysis of data from two parallel, multicenter, randomized, double-blind, placebo-controlled thyroxine replacement trials in pregnant women with either hypothyroxinemia or subclinical hypothyroidism who delivered at term. Body mass index was categorized as normal (18.5-24.9), overweight (25.0-29.9), or obese (30 or greater). We also evaluated early (20 weeks of gestation or less), late (greater than 20 weeks of gestation), and total gestational weight gain and categorized gestational weight gain as inadequate, adequate, and excessive per 2009 Institute of Medicine guidelines. Neurodevelopmental outcomes included 5-year Wechsler Preschool and Primary Scale of Intelligence and 3-year Differential Ability Scales-II. Linear and logistic regression analyses were performed and adjusted for maternal age, race-ethnicity, education, insurance status, parity, smoking and alcohol use, thyroid status (subclinical hypothyroidism or hypothyroxinemia), treatment group, gestational age at delivery, and neonatal sex.RESULTS:Of the 948 women included, 380 (40%), 305 (32%), and 263 (28%) had normal, overweight, and obese prepregnancy BMI, respectively. A total of 106 (11%), 212 (22%), and 630 (66%) of women had inadequate, adequate, and excessive total rates of gestational weight gain, respectively. Maternal differences among the BMI categories included race-ethnicity, education, insurance type, parity, and thyroid status (all P<.01), whereas the gestational weight gain groups only differed by parity (P<.001). In unadjusted analysis, children of obese (93.2±12.8; 88.5±13.3) and overweight (94.1±15.6; 89.6±16.0) women had lower Wechsler Preschool and Primary Scale of Intelligence and Differential Ability Scales-II scores, respectively, than normal-weight women (97.4±15.4; 93.9±16.0; P<.001 for all comparisons); however, in adjusted analysis, there were no differences in neurodevelopmental outcomes by maternal BMI. The association was primarily accounted for by race-ethnicity and education. In unadjusted and adjusted analyses, there were no differences in neurodevelopmental outcomes by adequacy of early, late, or total gestational weight gain.CONCLUSION:In women with either subclinical hypothyroidism or hypothyroxinemia, neither prepregnancy BMI nor gestational weight gain was associated with neurodevelopmental outcomes among children born at term in adjusted analyses.

Original languageEnglish (US)
Pages (from-to)1386-1393
Number of pages8
JournalObstetrics and gynecology
Volume132
Issue number6
DOIs
StatePublished - Dec 1 2018

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Weight Gain
Body Mass Index
Hypothyroidism
Parity
Aptitude
Intelligence
Education
Thyroid Gland
Mothers
Pregnancy
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Insurance Coverage
Maternal Age
Insurance
Thyroxine
Gestational Age
Pregnant Women
Linear Models
Logistic Models
Smoking

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Kominiarek, Michelle ; Smid, Marcela C. ; Mele, Lisa ; Casey, Brian M. ; Sorokin, Yoram ; Reddy, Uma M. ; Wapner, Ronald J. ; Thorp, John M. ; Saade, George R. ; Tita, Alan T.N. ; Rouse, Dwight J. ; Sibai, Baha ; Iams, Jay D. ; Mercer, Brian M. ; Tolosa, Jorge ; Caritis, Steve N. / Child Neurodevelopmental Outcomes by Prepregnancy Body Mass Index and Gestational Weight Gain. In: Obstetrics and gynecology. 2018 ; Vol. 132, No. 6. pp. 1386-1393.
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abstract = "OBJECTIVE:To study the association of prepregnancy body mass index (BMI) and gestational weight gain with child neurodevelopmental outcomes.METHODS:We performed a secondary analysis of data from two parallel, multicenter, randomized, double-blind, placebo-controlled thyroxine replacement trials in pregnant women with either hypothyroxinemia or subclinical hypothyroidism who delivered at term. Body mass index was categorized as normal (18.5-24.9), overweight (25.0-29.9), or obese (30 or greater). We also evaluated early (20 weeks of gestation or less), late (greater than 20 weeks of gestation), and total gestational weight gain and categorized gestational weight gain as inadequate, adequate, and excessive per 2009 Institute of Medicine guidelines. Neurodevelopmental outcomes included 5-year Wechsler Preschool and Primary Scale of Intelligence and 3-year Differential Ability Scales-II. Linear and logistic regression analyses were performed and adjusted for maternal age, race-ethnicity, education, insurance status, parity, smoking and alcohol use, thyroid status (subclinical hypothyroidism or hypothyroxinemia), treatment group, gestational age at delivery, and neonatal sex.RESULTS:Of the 948 women included, 380 (40{\%}), 305 (32{\%}), and 263 (28{\%}) had normal, overweight, and obese prepregnancy BMI, respectively. A total of 106 (11{\%}), 212 (22{\%}), and 630 (66{\%}) of women had inadequate, adequate, and excessive total rates of gestational weight gain, respectively. Maternal differences among the BMI categories included race-ethnicity, education, insurance type, parity, and thyroid status (all P<.01), whereas the gestational weight gain groups only differed by parity (P<.001). In unadjusted analysis, children of obese (93.2±12.8; 88.5±13.3) and overweight (94.1±15.6; 89.6±16.0) women had lower Wechsler Preschool and Primary Scale of Intelligence and Differential Ability Scales-II scores, respectively, than normal-weight women (97.4±15.4; 93.9±16.0; P<.001 for all comparisons); however, in adjusted analysis, there were no differences in neurodevelopmental outcomes by maternal BMI. The association was primarily accounted for by race-ethnicity and education. In unadjusted and adjusted analyses, there were no differences in neurodevelopmental outcomes by adequacy of early, late, or total gestational weight gain.CONCLUSION:In women with either subclinical hypothyroidism or hypothyroxinemia, neither prepregnancy BMI nor gestational weight gain was associated with neurodevelopmental outcomes among children born at term in adjusted analyses.",
author = "Michelle Kominiarek and Smid, {Marcela C.} and Lisa Mele and Casey, {Brian M.} and Yoram Sorokin and Reddy, {Uma M.} and Wapner, {Ronald J.} and Thorp, {John M.} and Saade, {George R.} and Tita, {Alan T.N.} and Rouse, {Dwight J.} and Baha Sibai and Iams, {Jay D.} and Mercer, {Brian M.} and Jorge Tolosa and Caritis, {Steve N.}",
year = "2018",
month = "12",
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doi = "10.1097/AOG.0000000000002974",
language = "English (US)",
volume = "132",
pages = "1386--1393",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
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Kominiarek, M, Smid, MC, Mele, L, Casey, BM, Sorokin, Y, Reddy, UM, Wapner, RJ, Thorp, JM, Saade, GR, Tita, ATN, Rouse, DJ, Sibai, B, Iams, JD, Mercer, BM, Tolosa, J & Caritis, SN 2018, 'Child Neurodevelopmental Outcomes by Prepregnancy Body Mass Index and Gestational Weight Gain', Obstetrics and gynecology, vol. 132, no. 6, pp. 1386-1393. https://doi.org/10.1097/AOG.0000000000002974

Child Neurodevelopmental Outcomes by Prepregnancy Body Mass Index and Gestational Weight Gain. / Kominiarek, Michelle; Smid, Marcela C.; Mele, Lisa; Casey, Brian M.; Sorokin, Yoram; Reddy, Uma M.; Wapner, Ronald J.; Thorp, John M.; Saade, George R.; Tita, Alan T.N.; Rouse, Dwight J.; Sibai, Baha; Iams, Jay D.; Mercer, Brian M.; Tolosa, Jorge; Caritis, Steve N.

In: Obstetrics and gynecology, Vol. 132, No. 6, 01.12.2018, p. 1386-1393.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Child Neurodevelopmental Outcomes by Prepregnancy Body Mass Index and Gestational Weight Gain

AU - Kominiarek, Michelle

AU - Smid, Marcela C.

AU - Mele, Lisa

AU - Casey, Brian M.

AU - Sorokin, Yoram

AU - Reddy, Uma M.

AU - Wapner, Ronald J.

AU - Thorp, John M.

AU - Saade, George R.

AU - Tita, Alan T.N.

AU - Rouse, Dwight J.

AU - Sibai, Baha

AU - Iams, Jay D.

AU - Mercer, Brian M.

AU - Tolosa, Jorge

AU - Caritis, Steve N.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - OBJECTIVE:To study the association of prepregnancy body mass index (BMI) and gestational weight gain with child neurodevelopmental outcomes.METHODS:We performed a secondary analysis of data from two parallel, multicenter, randomized, double-blind, placebo-controlled thyroxine replacement trials in pregnant women with either hypothyroxinemia or subclinical hypothyroidism who delivered at term. Body mass index was categorized as normal (18.5-24.9), overweight (25.0-29.9), or obese (30 or greater). We also evaluated early (20 weeks of gestation or less), late (greater than 20 weeks of gestation), and total gestational weight gain and categorized gestational weight gain as inadequate, adequate, and excessive per 2009 Institute of Medicine guidelines. Neurodevelopmental outcomes included 5-year Wechsler Preschool and Primary Scale of Intelligence and 3-year Differential Ability Scales-II. Linear and logistic regression analyses were performed and adjusted for maternal age, race-ethnicity, education, insurance status, parity, smoking and alcohol use, thyroid status (subclinical hypothyroidism or hypothyroxinemia), treatment group, gestational age at delivery, and neonatal sex.RESULTS:Of the 948 women included, 380 (40%), 305 (32%), and 263 (28%) had normal, overweight, and obese prepregnancy BMI, respectively. A total of 106 (11%), 212 (22%), and 630 (66%) of women had inadequate, adequate, and excessive total rates of gestational weight gain, respectively. Maternal differences among the BMI categories included race-ethnicity, education, insurance type, parity, and thyroid status (all P<.01), whereas the gestational weight gain groups only differed by parity (P<.001). In unadjusted analysis, children of obese (93.2±12.8; 88.5±13.3) and overweight (94.1±15.6; 89.6±16.0) women had lower Wechsler Preschool and Primary Scale of Intelligence and Differential Ability Scales-II scores, respectively, than normal-weight women (97.4±15.4; 93.9±16.0; P<.001 for all comparisons); however, in adjusted analysis, there were no differences in neurodevelopmental outcomes by maternal BMI. The association was primarily accounted for by race-ethnicity and education. In unadjusted and adjusted analyses, there were no differences in neurodevelopmental outcomes by adequacy of early, late, or total gestational weight gain.CONCLUSION:In women with either subclinical hypothyroidism or hypothyroxinemia, neither prepregnancy BMI nor gestational weight gain was associated with neurodevelopmental outcomes among children born at term in adjusted analyses.

AB - OBJECTIVE:To study the association of prepregnancy body mass index (BMI) and gestational weight gain with child neurodevelopmental outcomes.METHODS:We performed a secondary analysis of data from two parallel, multicenter, randomized, double-blind, placebo-controlled thyroxine replacement trials in pregnant women with either hypothyroxinemia or subclinical hypothyroidism who delivered at term. Body mass index was categorized as normal (18.5-24.9), overweight (25.0-29.9), or obese (30 or greater). We also evaluated early (20 weeks of gestation or less), late (greater than 20 weeks of gestation), and total gestational weight gain and categorized gestational weight gain as inadequate, adequate, and excessive per 2009 Institute of Medicine guidelines. Neurodevelopmental outcomes included 5-year Wechsler Preschool and Primary Scale of Intelligence and 3-year Differential Ability Scales-II. Linear and logistic regression analyses were performed and adjusted for maternal age, race-ethnicity, education, insurance status, parity, smoking and alcohol use, thyroid status (subclinical hypothyroidism or hypothyroxinemia), treatment group, gestational age at delivery, and neonatal sex.RESULTS:Of the 948 women included, 380 (40%), 305 (32%), and 263 (28%) had normal, overweight, and obese prepregnancy BMI, respectively. A total of 106 (11%), 212 (22%), and 630 (66%) of women had inadequate, adequate, and excessive total rates of gestational weight gain, respectively. Maternal differences among the BMI categories included race-ethnicity, education, insurance type, parity, and thyroid status (all P<.01), whereas the gestational weight gain groups only differed by parity (P<.001). In unadjusted analysis, children of obese (93.2±12.8; 88.5±13.3) and overweight (94.1±15.6; 89.6±16.0) women had lower Wechsler Preschool and Primary Scale of Intelligence and Differential Ability Scales-II scores, respectively, than normal-weight women (97.4±15.4; 93.9±16.0; P<.001 for all comparisons); however, in adjusted analysis, there were no differences in neurodevelopmental outcomes by maternal BMI. The association was primarily accounted for by race-ethnicity and education. In unadjusted and adjusted analyses, there were no differences in neurodevelopmental outcomes by adequacy of early, late, or total gestational weight gain.CONCLUSION:In women with either subclinical hypothyroidism or hypothyroxinemia, neither prepregnancy BMI nor gestational weight gain was associated with neurodevelopmental outcomes among children born at term in adjusted analyses.

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