Association between Perinatal Outcomes and Maternal Risk Factors: A Cohort Study

Medicina (Kaunas). 2024 Jun 29;60(7):1071. doi: 10.3390/medicina60071071.

Abstract

Background and Objectives: The aim of this study was to analyze the association between maternal risk factors, such as age, body mass index (BMI), and cigarette smoking, and perinatal outcomes. Materials and Methods: We conducted a retrospective analysis based on prospectively collected data at Hospital Universitario de Torrejón (Madrid, Spain) between September 2017 and December 2019. All pregnant women with singleton pregnancies and non-malformed live fetuses attending their routine ultrasound examination at 11+0 to 13+6 weeks' gestation were invited to participate. The association between preeclampsia, preterm birth, gestational diabetes mellitus (GDM), small-for-gestational-age (SGA) or fetal-growth-restricted (FGR) neonates, and type of delivery and maternal age, BMI, and cigarette smoking was studied. Logistic mixed models were used to analyze the data. Results: A total of 1921 patients were included in the analysis. Women who were ≥40 years old had a significantly higher risk of having GDM (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.08 to 2.36) and SGA neonates (OR 1.54, 95% CI 1.00 to 2.37). Women with a BMI < 18 had an increased rate of giving birth to SGA and FGR neonates (OR 3.28, 95% CI 1.51 to 7.05, and OR 3.73, 95% CI 1.54 to 8.37, respectively), whereas women with a BMI ≥ 35 had a higher risk of GDM (OR 3.10, 95% CI 1.95 to 4.89). Smoking increased the risk of having SGA and FGR neonates (OR 1.83, 95% CI 1.36 to 2.46, and OR 1.91, 95% CI 1.29 to 2.78). Conclusions: Advanced maternal age, low or high BMI, and smoking status are significant risk factors for pregnancy complications. Both clinicians and society should concentrate their efforts on addressing these factors to enhance reproductive health.

Keywords: age; birth weight; body mass index; cigarette smoking; diabetes; fetal; labor; obesity; preeclampsia; pregnancy.

MeSH terms

  • Adult
  • Body Mass Index*
  • Cohort Studies
  • Diabetes, Gestational* / epidemiology
  • Female
  • Fetal Growth Retardation / epidemiology
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Maternal Age
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Outcome* / epidemiology
  • Premature Birth / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Spain / epidemiology

Grants and funding

Gil MM was awarded a Leonardo grant (Biomedicina 2020) from the BBVA Foundation to conduct this study. This study was also supported by a grant from Instituto de Salud Carlos III (ISCIII) PI18/01749. iMaterna Foundation (Registry No: 2148) provided smaller grants to support the study and General Electrics (GE Medical Systems, Zipf, Austria) via Health Net Connections (HNC, Spain) provided the software (ViewPoint® Version 5) to collect the data. None of these bodies had any involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.