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Maternal prepregnancy BMI linked to cerebral palsy risk in offspring

Expecting mothers who are overweight and obese during prepregnancy had a 60% excess risk for their children developing cerebral palsy, according to data published in Pediatrics.

“[Cerebral palsy (CP)] affects around two per 1,000 children and is the most common cause of physical disability in childhood,” Ingeborg Forthun, M.Econ, of the department of global public health and primary care, at the University of Bergen, in Norway, and colleagues wrote. “… The prevalence of overweight and obesity among pregnant women is increasing worldwide with adverse effects on maternal and child health.”

To analyze the association between maternal prepregnancy BMI and the risk for CP in the offspring, the researchers reviewed data from two population-based, prospective birth cohorts: The Norwegian Mother and Child Cohort Study and the Danish National Birth Cohort. The study population included 188,788 children, and there were 390 eligible cases of CP, or 2.1 per 1,000 live-born children.

The researchers classified prepregnancy BMI as underweight (BMI < 18.5), lower-normal weight (BMI 18.5-22.9), upper-normal weight (BMI 23- 24.9), overweight (BMI 25-29.9), or obese, (BMI ≥ 30. They obtained CP diagnoses from national registries. Associations were determined using log-binomial regression models.

According to the researchers, mothers in the upper-normal weight group, compared with the lower-normal group, had a 40% excess risk of having a child with CP (RR = 1.35; 95% CI, 1.03-1.78). Excess risk was 60% for both overweight mothers (RR = 1.56; 95% CI, 1.21-2.01) and obese mothers (RR = 1.55; 95% CI, 1.11-2.18). In addition, the risk for CP increased approximately 4% for each unit increase in BMI (RR = 1.04; 95% CI, 1.02-1.06). There was little change in the estimates after adjusting for maternal occupational status, age and smoking habits, the researchers wrote.

“We found a continuously increasing risk of CP with increasing maternal prepregnancy BMI,” Forthun and colleagues wrote. “The risk was significantly elevated both for women in the upper normal weight, overweight and obese groups compared with normal weight women. Although we cannot draw any conclusions about the underlying mechanisms for this association, the clinical implications may become all the more important if prepregnancy BMI continues to increase.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.