Overweight is a significant contributing factor to complications during pregnancy and childbirth, and this applies both to women born in Sweden and to those who have moved here, an aspect that has not been studied in depth so far. Interventions that promote a healthy weight have the potential to prevent complications for all women, the researchers conclude.
The study was conducted by researchers from Linköping University and Karolinska Institutet and is published on The Lancet Public Health.
Why it is important to maintain a balanced body weight during pregnancy
In Sweden and similar high-income countries, there are inequalities in women’s health during pregnancy and childbirth. Women who have emigrated to Sweden from other countries are more affected by various serious complications than women born in Sweden.
The risk of complications is especially high in women born in certain parts of the world. It’s unclear why, but many different factors that influence health may contribute to this inequality. One possible factor is body weight. It is more common among migrant women from certain regions to be underweight, overweight, or obese (a disease in which the person is overweight with a BMI of 30 or more) when they become pregnant.
“We know that overweight and obesity are linked to many complications during pregnancy and childbirth for women born in Sweden. Therefore, we wanted to investigate whether inequalities in pregnancy complications between women born in different countries can to some extent be explained by differences in body weight.”
“If you know that there are health inequalities, you want to find out why, in order to be able to do something about the inequalities in the next step,” says Pontus Henriksson, senior associate professor in the Department of Health, Medicine and Care Sciences at Linköping University, who led the study.
What’s new about this study is that the researchers were able to estimate the extent to which complications, such as gestational diabetes, could be avoided if all women had a normal weight at the time of pregnancy.
“For example, we concluded that approximately half of all cases of gestational diabetes could potentially be prevented. This applies to both Swedish-born and foreign-born women,” says Maryam Shirvanifar, a doctoral candidate at Linköping University and first author of the study.
Researchers believe that efforts to promote a healthy weight could help all women, regardless of where they were born. “A healthy weight is good for everyone. The earlier in life you start it, the better, because once obesity is established, it is difficult to cure,” says Henriksson.
The study paints a complex picture. The importance of body weight varies with different complications. For example, high body weight contributes more to gestational diabetes than other complications. But what about being underweight in early pregnancy? How does it affect risks? To the researchers’ surprise, underweight did not appear to contribute significantly to the complications studied.
In their study, the researchers followed nearly two million pregnancies, basically all births that occurred in Sweden from 2000 to 2020. The researchers studied eight complications that can affect the mother or baby during pregnancy, or during and after giving birth . Using data from several national registries, they were able to investigate the relationship between a woman’s BMI at the first prenatal visit and complications depending on the region of the world where the mother was born.
In their analyses, the researchers took into account several factors, including socio-economic data. However, some factors that could influence a woman’s health during pregnancy and childbirth, such as the quality of treatment in health care, communication barriers, migration-related stress, and differences in health-promoting behaviors, could not be investigated in the current study as it uses registry data. Therefore, further research is needed to study more factors that may influence health during pregnancy in different groups.
In their study, the researchers looked at eight different complications in the mother and baby: serious complications in the mother that could be fatal, preeclampsia, gestational diabetes, infant mortality in the first year of life, preterm birth (before 37 weeks of pregnancy), and extremely preterm birth (before 28 weeks of pregnancy), low Apgar score (assessment of the viability of the newborn), large baby (in relation to the duration of the pregnancy) and small baby (in relation to the duration of the pregnancy).
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