Effect of the interaction between advanced maternal age and pre-pregnancy BMI on pre-eclampsia and GDM in Central China

Mengting Sun; Manjun Luo; Tingting Wang; Jianhui Wei; Senmao Zhang; Jing Shu; Taowei Zhong; Yiping Liu; Qian Chen; Ping Zhu; Jiabi Qin

doi:10.1136/bmjdrc-2023-003324

Effect of the interaction between advanced maternal age and pre-pregnancy BMI on pre-eclampsia and GDM in Central China

BMJ Open Diabetes Res Care. 2023 Apr;11(2):e003324. doi: 10.1136/bmjdrc-2023-003324.

Authors

Mengting Sun¹, Manjun Luo¹, Tingting Wang^{2

3}, Jianhui Wei¹, Senmao Zhang¹, Jing Shu¹, Taowei Zhong¹, Yiping Liu¹, Qian Chen¹, Ping Zhu⁴, Jiabi Qin^{2

3

5}

Affiliations

¹ Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
² Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China qinjiabi123@163.com wangting91123@126.com.
³ National Health Committee (NHC) Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China.
⁴ Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
⁵ Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, Hunan, China.

Abstract

Introduction: To investigate the independent and combined effects of advanced maternal age and pre-pregnancy body mass index (BMI) on the risk of pre-eclampsia and gestational diabetes mellitus (GDM).

Research design and methods: Logistic regression models were used to estimate the OR and 95% CIs of pre-eclampsia and GDM with advanced maternal age and pre-pregnancy BMI, respectively, and the interaction between advanced maternal age and pre-pregnancy BMI. We also used causal mediation analysis to assess the mediating role of pre-pregnancy BMI on maternal age-pre-eclampsia/GDM associations.

Results: In this study, 788 cases (2.31%) were diagnosed with pre-eclampsia and 5430 cases (15.92%) were diagnosed with GDM. We found that advanced maternal age was associated with a higher risk for pre-eclampsia and GDM, with adjusted ORs (aORs) of 1.74 (95% CI 1.49-2.05) and 1.76 (95% CI 1.65-1.89) after adjusting for potential confounders, respectively. In addition, maternal pre-pregnancy overweight/obesity was associated with the risk of pre-eclampsia and GDM, with the corresponding aORs of 3.64 (95% CI 3.12-4.24) and 1.71 (95% CI 1.60-1.85), respectively. We also observed the interaction between maternal age and pre-pregnancy BMI for the risk of pre-eclampsia/GDM (all p for interaction <0.001). In the mediating effect analysis, we found that maternal pre-pregnancy BMI mediated the associations between maternal age and the development of pre-eclampsia and GDM.

Conclusions: Advanced maternal age and pre-pregnancy BMI were respectively associated with the risk of pre-eclampsia/GDM, and there was an interaction between the two risk factors. In addition, we found that pre-pregnancy BMI served as a mediator of the association between advanced maternal age and the risk of pre-eclampsia/GDM, providing an essential target for the prevention of maternal overweight/obesity.

Keywords: Ageing; Body Mass Index; Diabetes, Gestational; Pregnancy, High-Risk.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Body Mass Index
China / epidemiology
Diabetes, Gestational* / epidemiology
Female
Humans
Maternal Age
Obesity, Maternal*
Overweight / complications
Overweight / epidemiology
Pre-Eclampsia* / epidemiology
Pre-Eclampsia* / etiology
Pregnancy