A new South Korean study suggests that maternal obesity before pregnancy is associated with higher risks of epilepsy and intellectual disability in children. The research, published in the International Journal of Obesity, found no significant link between maternal underweight and adverse neurodevelopmental outcomes after adjusting for maternal and neonatal factors.
Rising Maternal Obesity Rates
Obesity among women of reproductive age is increasing worldwide, including in Asia. In South Korea, growing rates of maternal obesity have raised public health concerns. The World Health Organization recommends lower BMI thresholds for Asian populations due to elevated health risks at lower BMI levels.
Study Design and Data Sources
Researchers analyzed 779,091 mother-infant pairs from the Korean National Health Information Database, drawn from over 2.28 million live births. Maternal BMI, measured within three years before delivery, was classified using Asia-Pacific categories: underweight, normal, overweight, obese class I, and obese class II.
The study included maternal health conditions (hypertension, diabetes, depression) and neonatal factors (gestational age, birth weight, NICU admission, congenital anomalies). Neurodevelopmental diagnoses—autism spectrum disorder, ADHD, intellectual disability, cerebral palsy, and epilepsy—were tracked from birth to age five.
Key Findings
Severe maternal obesity was initially linked to autism spectrum disorder, ADHD, intellectual disability, cerebral palsy, and epilepsy.
After full adjustment for maternal and neonatal factors, only epilepsy and intellectual disability remained significantly associated with higher maternal BMI. Hazard ratios ranged from 1.08 to 1.37 across BMI categories.
Maternal underweight showed no association with neurodevelopmental disorders in fully adjusted models.
Maternal and Neonatal Characteristics
Women with higher BMI were more likely to be older and have gestational diabetes, chronic hypertension, or depression. Their infants had higher birth weights, were more likely to be delivered by cesarean section, admitted to the NICU, or require resuscitation.
Implications and Mechanisms
The study suggests maternal obesity may influence fetal neurodevelopment through metabolic, inflammatory, hormonal, or epigenetic pathways. While some associations with ASD, ADHD, and cerebral palsy disappeared after adjustment, the persistent risk for epilepsy and intellectual disability highlights the importance of preconception weight management.
Strengths and Limitations
Strengths of the study include its large, nationwide sample and comprehensive adjustment for confounding factors. Limitations include reliance on pre-pregnancy BMI measured up to three years before conception, absence of gestational weight gain and socioeconomic data, and a follow-up limited to age five.
Conclusion
This population-based study reinforces the importance of maternal health before pregnancy. Maintaining a healthy BMI may reduce the risk of certain neurodevelopmental disorders in children, particularly epilepsy and intellectual disability.
Related topics
