Background
Methods
Study design
Prepregnancy body mass index (pBMI)
Parity status
Covariates
Gestational weight gain during pregnancy (GWG) according to IOM recommendations
Demographic and socioeconomic factors
Health behaviors during pregnancy
Maternal, fetal and neonatal outcomes
Statistical analyses
Results
Study sample
Subject characteristics
Prepregnancy BMI | ||||||
---|---|---|---|---|---|---|
All | Underweight | Normal weight | Overweight | Obesity |
p-valuea
| |
n = 3208 |
n = 240 |
n = 2067 |
n = 583 |
n = 318 | ||
% | ||||||
Maternal age (years) (n = 3208) | ||||||
18-24 | 17.0 | 28.6 | 15.9 | 16.2 | 16.9 | <10−3
|
25-29 | 32.9 | 34.2 | 32.1 | 34.2 | 34.5 | |
30-34 | 31.1 | 26.6 | 33.0 | 30.8 | 22.9 | |
≥ 35 | 19.0 | 10.7 | 19.0 | 18.8 | 25.7 | |
Maternal country of birth (n = 3208) | ||||||
France (mainland and overseas) | 83.8 | 83.3 | 84.9 | 82.7 | 79.1 | 0.03 |
Africa | 8.7 | 5.0 | 7.9 | 11.8 | 11.4 | |
Europa, Asia, America, Oceania | 7.5 | 11.7 | 7.2 | 5.5 | 9.5 | |
Parity (n = 3208) | ||||||
1 child | 43.3 | 48.1 | 45.4 | 37.3 | 37.3 | <10−3
|
2 children or more | 56.7 | 51.9 | 54.6 | 62.7 | 62.7 | |
Marital status (n = 3208) | ||||||
Married | 47.7 | 42.0 | 47.0 | 51.7 | 49.7 | 0.08 |
Unmarried | 52.3 | 58.0 | 53.0 | 48.3 | 50.3 | |
Maternal education (n = 3208) | ||||||
Primary school | 2.4 | 5.4 | 1.2 | 4.0 | 5.1 | <10−3
|
Junior high school | 20.7 | 22.6 | 18.5 | 21.8 | 30.7 | |
High school | 23.6 | 21.2 | 22.5 | 25.7 | 29.5 | |
University | 53.3 | 50.8 | 57.8 | 48.5 | 34.7 | |
Maternal occupation (n = 3208) | ||||||
Farmer, craftswoman, merchant | 2.1 | 2.2 | 2.5 | 0.8 | 2.4 | <10−3
|
Management profession | 15.6 | 13.0 | 18.5 | 10.6 | 8.2 | |
Intermediate profession | 47.1 | 44.9 | 46.6 | 51.4 | 43.2 | |
Manual worker | 7.3 | 6.8 | 7.0 | 6.4 | 10.9 | |
Unemployed | 6.8 | 4.0 | 5.8 | 9.8 | 10.1 | |
Missing | 21.1 | 29.1 | 19.5 | 21.0 | 25.2 | |
Time of return to workb (n = 3208) | ||||||
<= 4 months | 34.4 | 32.5 | 37.1 | 29.9 | 27.5 | <10−3
|
]4 months-6 months] | 12.5 | 14.4 | 13.2 | 10.0 | 11.3 | |
]6 months-12 months] | 24.4 | 26.9 | 23.9 | 27.1 | 20.9 | |
Did not go back at 12 months | 28.7 | 26.2 | 25.9 | 32.9 | 40.3 | |
Smoking before/during pregnancy (n = 3208) | ||||||
No smoking before or during | 67.6 | 62.0 | 66.8 | 70.4 | 71.3 | 0.07 |
Smoking before but not during | 15.7 | 14.8 | 16.7 | 13.5 | 14.1 | |
Smoking before and during | 16.7 | 23.2 | 16.5 | 16.1 | 14.7 | |
Alcohol during pregnancy (n = 3198) | ||||||
No consumption | 93.9 | 94.9 | 93.6 | 94.1 | 93.9 | 0.87 |
Consumption | 6.1 | 5.1 | 6.4 | 5.9 | 6.1 | |
Antenatal classes (n = 3205) | ||||||
Attended | 53.2 | 51.2 | 56.8 | 48.8 | 39.0 | <10−3
|
Not attended | 46.8 | 48.8 | 43.2 | 51.2 | 61.0 |
Prepregnancy BMI | ||||||
---|---|---|---|---|---|---|
All | Underweight | Normal weight | Overweight | Obesity |
p-valuea
| |
n = 3208 |
n = 240 |
n = 2067 |
n = 583 |
n = 318 | ||
% | ||||||
Type of pregnancy (n = 3208) | ||||||
Multiple | 1.3 | 0.9 | 1.3 | 1.5 | 1.6 | 0.86 |
Single | 98.7 | 99.1 | 98.7 | 98.5 | 98.4 | |
Mean of GWG (in kg) (n = 3162) | ||||||
13.2 | 14.5 | 13.9 | 12.6 | 8.7 | <10−3
| |
Gestational weight gain (n = 3162)b
| ||||||
Within IOM | 35.5 | 48.8 | 36.5 | 29.5 | 29.0 | <10−3
|
Below IOM | 27.5 | 35.5 | 31.5 | 12.1 | 23.5 | |
Above IOM | 37.0 | 15.7 | 32.0 | 58.3 | 47.5 | |
Gestational diabetes mellitus (n = 3204) | ||||||
No | 92.3 | 98.6 | 94.4 | 88.8 | 80.7 | <10−3
|
Yes | 7.7 | 1.4 | 5.6 | 11.2 | 19.3 | |
Hypertensive complicationsc (n = 3204) | ||||||
No | 96.5 | 98.4 | 97.6 | 96.8 | 87.4 | <10−3
|
Yes | 3.5 | 1.6 | 2.4 | 3.2 | 12.6 | |
Delivery mode (n = 3200) | ||||||
Vaginal | 81.4 | 89.6 | 82.9 | 77.5 | 73.2 | <10−3
|
Cesarean | 18.6 | 10.4 | 17.1 | 22.5 | 26.8 | |
Gestational age at birth (n = 3183) | ||||||
≥ 37 amenorrhea weeks | 96.4 | 94.3 | 96.5 | 96.8 | 96.3 | 0.50 |
33-36 amenorrhea weeks | 3.6 | 5.7 | 3.5 | 3.2 | 3.7 | |
Infant’s sex (n = 3200) | ||||||
Male | 49.4 | 48.6 | 49.6 | 49.6 | 47.8 | 0.95 |
Female | 50.6 | 51.4 | 50.4 | 50.4 | 52.2 | |
Infant’s birth weight (n = 3202) | ||||||
[2.5 kg-4 kg[ | 89.0 | 85.7 | 89.8 | 89.1 | 86.4 | <10−3
|
≥4 kg | 7.4 | 3.8 | 6.8 | 8.8 | 11.1 | |
<2.5 kg | 3.6 | 10.5 | 3.4 | 2.2 | 2.6 | |
Apgar score at 5 min (n = 3181) | ||||||
10 | 94.7 | 96.5 | 95.2 | 93.2 | 93.6 | 0.40 |
8-9 | 4.6 | 3.1 | 4.4 | 5.9 | 4.8 | |
≤7 | 0.7 | 0.3 | 0.4 | 1.0 | 1.6 |
Primiparous (n = 1335) | Multiparous (n = 1814) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Underweight | Overweight | Obesity | Underweight | Overweight | Obesity | |||||||
n = 107 |
n = 214 |
n = 114 |
n = 130 |
n = 357 |
n = 197 | |||||||
OR | [95% CI] | OR | [95% CI] | OR | [95% CI] | OR | [95% CI] | OR | [95% CI] | OR | [95% CI] | |
Maternal age (years) | ||||||||||||
18-24 | 2.07 | [0.97-4.39] | 0.80 | [0.48-1.32] | 1.27 | [0.57-2.85] | 3.03 | [1.57-5.87] | 0.73 | [0.39-1.37] | 0.98 | [0.49-1.97] |
25-29 | 1.55 | [0.85-2.82] | 0.69 | [0.46-1.04] | 2.09 | [1.13-3.87] | 1.28 | [0.80-2.05] | 1.39 | [1.01-1.93] | 1.11 | [0.72-1.72] |
30-34 | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
≥ 35 | 0.84 | [0.30-2.35] | 0.70 | [0.37-1.33] | 2.01 | [0.94-4.28] | 0.74 | [0.42-1.32] | 1.04 | [0.73-1.48] | 1.45 | [0.93-2.25] |
Maternal country of birth | ||||||||||||
France (mainland and overseas) | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Maghreb and Sub-Saharan Africa | 1.09 | [0.34-3.49] | 0.99 | [0.37-2.67] | 0.81 | [0.25-2.61] | 0.54 | [0.17-1.67] | 1.31 | [0.78-2.20] | 0.77 | [0.43-1.38] |
Europe, Asia, America, Oceania | 3.16 | [1.52-6.54] | 0.75 | [0.34-1.67] | 0.78 | [0.22-2.79] | 1.21 | [0.50-2.89] | 0.49 | [0.22-1.09] | 1.64 | [0.79-3.41] |
Maternal education | ||||||||||||
Primary school | 3.73 | [1.10-12.68] | 1.77 | [0.53-5.91] | 0.69 | [0.09-5.38] | 3.21 | [1.01-10.17] | 4.59 | [1.89-11.16] | 6.30 | [2.40-16.57] |
Junior high school | 1.42 | [0.74-2.72] | 0.96 | [0.56-1.62] | 1.59 | [0.83-3.07] | 0.54 | [0.29-1.00] | 1.42 | [0.96-2.10] | 2.89 | [1.81-4.64] |
High school | 0.93 | [0.49-1.78] | 1.52 | [1.01-2.29] | 2.22 | [1.33-3.73] | 0.79 | [0.46-1.35] | 0.98 | [0.68-1.41] | 1.86 | [1.18-2.93] |
University | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Maternal occupation | ||||||||||||
Farmer, craftswoman, merchant, entrepreneur | 0.92 | [0.25-3.39] | 0.31 | [0.08-1.14] | 1.15 | [0.26-5.04] | 0.83 | [0.22-3.14] | 0.25 | [0.08-0.75] | 0.71 | [0.17-2.86] |
Management profession | 0.97 | [0.50-1.87] | 0.61 | [0.37-1.00] | 1.12 | [0.51-2.49] | 0.64 | [0.35-1.19] | 0.67 | [0.42-1.06] | 0.47 | [0.22-1.05] |
Intermediate profession | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Manual worker | 0.78 | [0.27-2.23] | 0.49 | [0.21-1.14] | 0.84 | [0.34-2.05] | 0.97 | [0.46-2.04] | 0.71 | [0.41-1.20] | 1.42 | [0.83-2.45] |
Unemployed | 0.55 | [0.18-1.76] | 1.82 | [0.84-3.93] | 1.85 | [0.75-4.57] | 0.30 | [0.08-1.08] | 1.29 | [0.70-2.39] | 1.48 | [0.76-2.88] |
Missing | 1.36 | [0.74-2.51] | 0.67 | [0.40-1.13] | 1.57 | [0.92-2.69] | 1.39 | [0.84-2.30] | 0.94 | [0.67-1.33] | 0.96 | [0.62-1.50] |
Smoking before/during pregnancy pregnancy) | ||||||||||||
No smoking before or during | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Smoking before, but not during | 0.92 | [0.51-1.66] | 0.91 | [0.60-1.38] | 0.77 | [0.42-1.42] | 0.99 | [0.55-1.80] | 0.47 | [0.30-0.73] | 0.61 | [0.36-1.05] |
Smoking before and during | 1.24 | [0.67-2.27] | 0.50 | [0.31-0.79] | 0.56 | [0.30-1.05] | 1.27 | [0.74-2.16] | 0.99 | [0.68-1.43] | 0.65 | [0.40-1.05] |
Antenatal classes | ||||||||||||
Attended | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Not attended | 1.25 | [0.70-2.22] | 1.30 | [0.83-2.03] | 1.36 | [0.80-2.31] | 0.99 | [0.65-4.52] | 1.02 | [0.76-1.38] | 1.77 | [1.16-2.72] |
Primiparous (n = 1335) | Multiparous (n = 1814) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Underweight | Overweight | Obesity | Underweight | Overweight | Obesity | |||||||
n = 107 |
n = 214 |
n = 114 |
n = 130 |
n = 357 |
n = 197 | |||||||
OR | [95% CI] | OR | [95% CI] | OR | [95% CI] | OR | [95% CI] | OR | [95% CI] | OR | [95% CI] | |
Gestational weight gain | ||||||||||||
Within IOM | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Below IOM | 0.70 | [0.42-1.16] | 0.47 | [0.26-0.85] | 0.81 | [0.44-1.50] | 0.97 | [0.63-1.51] | 0.39 | [0.26-0.60] | 0.84 | [0.53-1.32] |
Above IOM | 0.20 | [0.10-0.38] | 2.87 | [1.93-4.26] | 1.39 | [0.82-2.37] | 0.64 | [0.37-1.10] | 2.27 | [1.68-3.06] | 1.82 | [1.20-2.76] |
Gestational diabetes mellitus | ||||||||||||
No | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Yes | 0.27 | [0.06-1.26] | 1.51 | [0.80-2.87] | 2.80 | [1.56-5.01] | 0.27 | [0.06-1.15] | 3.43 | [2.17-5.43] | 5.16 | [3.15-8.46] |
Hypertensive complications | ||||||||||||
No | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Yes | 0.74 | [0.16-3.37] | 1.46 | [0.62-3.43] | 3.80 | [1.83-7.89] | 0.51 | [0.06-4.14] | 0.72 | [0.28-1.88] | 8.13 | [3.97-16.64] |
Delivery mode | ||||||||||||
Vaginal | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
Caesarean | 0.77 | [0.43-1.37] | 1.38 | [0.92-2.07] | 1.33 | [0.80-2.23] | 0.39 | [0.19-0.81] | 1.28 | [0.90-1.82] | 1.80 | [1.18-2.77] |
Infant’s birth weight | ||||||||||||
[2.5 kg-4 kg[ | 1 | 1 | 1 | 1 | 1 | 1 | ||||||
≥ 4 kg | 0.43 | [0.06-2.94] | 1.40 | [0.70-2.77] | 1.18 | [0.36-3.86] | 0.84 | [0.38-1.87] | 0.80 | [0.52-1.22] | 1.70 | [1.03-2.80] |
< 2.5 kg | 2.47 | [1.14-5.33] | 1.03 | [0.37-2.90] | 0.83 | [0.28-2.47] | 4.93 | [2.36-10.32] | 0.48 | [0.16-1.41] | 0.56 | [0.14-2.18] |