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

• Published in: BMJ open diabetes research & care Vol. 11; no. 2; p. e003324
• Main Authors: Sun, Mengting, Luo, Manjun, Wang, Tingting, Wei, Jianhui, Zhang, Senmao, Shu, Jing, Zhong, Taowei, Liu, Yiping, Chen, Qian, Zhu, Ping, Qin, Jiabi
• Format: Journal Article
• Language: English
• Published: England American Diabetes Association 01.04.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Ageing; Body Mass Index; China - epidemiology; Diabetes, Gestational; Diabetes, Gestational - epidemiology; Female; Gestational diabetes; Humans; Maternal Age; Metabolism; Obesity; Obesity, Maternal; Overweight - complications; Overweight - epidemiology; Pre-Eclampsia - epidemiology; Pre-Eclampsia - etiology; Preeclampsia; Pregnancy; Pregnancy complications; Pregnancy, High-Risk; Womens health; China; Body Mass Index; Diabetes, Gestational; Pregnancy, High-Risk; Ageing
• ISSN: 2052-4897; 2052-4897
• DOI: 10.1136/bmjdrc-2023-003324

IntroductionTo 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 methodsLogistic 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.ResultsIn 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.ConclusionsAdvanced 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.