Parental preconception BMI and risk of adverse birth outcomes in 8 million parent-child triads: a nationwide population-based cohort study in China
Abstract
BACKGROUND
Maternal obesity has been identified as a risk factor for adverse birth outcomes, but the role of paternal obesity (separately and in combination with maternal obesity) on perinatal outcomes remains to be determined. Therefore, this study aims to investigate the independent and joint associations of paternal and maternal BMI with adverse birth outcomes in the general population in China.
METHODS
This population-based cohort study used data from the National Free Preconception Checkups Project between 2010 and 2020. Parent-child triads with available data on parental preconception BMI and birth outcomes were included. The outcomes included spontaneous abortion, medically induced abortion, preterm birth, small for gestational age (SGA), large for gestational age (LGA), birth defects, and perinatal death. Restricted cubic spline analyses were performed to assess the dose-response relationship and robust Poisson regression models were applied to quantify the risk ratios (RRs) and 95% CIs.
FINDINGS
We included 8 787 096 parent-child triads, with an average age of 26·18 (SD 4·33) years for mothers and 27·83 (4·73) years for fathers. Restricted cubic spline analyses showed robust monotonic associations for both maternal and paternal BMI with risk of LGA (positive association) and SGA (inverse association). Both maternal and paternal BMI showed J-shaped associations with all other adverse birth outcomes examined. Compared with a healthy BMI in both parents, we found that…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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