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Tuesday, November 13, 2007

Maternal Obesity and Neonatal Risk

Many of you are probably aware of the increasing discussion on the role of maternal obesity and excessive pregnancy-related weight gain as a key risk factor for childhood obesity.

In fact, some folks now seriously believe that this is the real reason why the pediatric obesity epidemic appears to be spiraling out of control.

Both animal studies and human observational data strongly support the notion that intrauterine epigenetic modification together with early post-natal influences on brain development may play an important role. A joint researcher team from the UofA and the UofC currently has a team grant in on exactly this issue.

Now a recent study from Denmark delivers another important reason for addressing maternal obesity. Nohr and colleagues, examined the relationship between prepregnancy BMI and neonatal mortality in 85,375 liveborn singletons of mothers in the Danish National Birth Cohort (1996-2002). Information about pregnancy outcomes and neonatal deaths (n=230) was obtained from national registers. Compared with infants of mothers who were at a normal weight before pregnancy, neonatal mortality was increased in infants of mothers who were overweight or obese (adjusted hazard ratios 1.7 and 1.6, respectively).

This observation of increased infant risk with maternal obesity is very much in line with previous reports, for e.g. a study by Heddersen and colleagues, who analysed a cohort of 45,245 women who delivered singletons at Kaiser Permanente Medical Care Program Northern California in 1996–1998 in which women who gained more than recommended by the IOM were three times more likely to have an infant with macrosomia than women whose weight gain was in the recommended range.

This is relevant to us, because currently about 10% or mothers in our health region are obese. Should WW be working with the maternal and neonatal program on this? I reckon this is well worth looking at.

Indeed, if there is any merit to these recent findings then aggressively targeting maternal obesity may help break the trans-generational obesity cycle and prevent obesity in the next generation.


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