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They also increase the risk of extremely preterm (EP, i.e., &lt;27\u2009weeks' gestational age) births. However, the association between maternal BMI and outcomes for EP babies is poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used a cross\u2010country design, bringing together the following three population\u2010based, prospective, national EP birth cohorts: EXPRESS (Sweden, 2004\u20132007); EPICure 2 (UK, 2006); and EPIPAGE 2 (France, 2011). We included all singleton births at 22 to 26\u2009weeks' gestational age with a live fetus at maternal hospital admission. Our exposure was maternal prepregnancy BMI, i.e., underweight, reference, overweight, or obesity. Odds ratios (OR) for survival without severe neonatal morbidity to hospital discharge according to maternal BMI were calculated using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1396 babies were born to mothers in the reference group, 140 to those with underweight, 719 to those with overweight, 556 to those with obesity, and 445 to those with missing BMI information. There was no difference in survival without major neonatal morbidity (reference, 22%; underweight, 26%, OR, 1.31, 95% CI: 0.82\u20132.08; overweight, 23%, OR, 1.00, 95% CI: 0.77\u20131.29; obesity, 19%, OR, 0.94, 95% CI: 0.70\u20131.25).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No associations were seen between maternal BMI and outcomes for EP babies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.24241","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T02:08:16Z","timestamp":1738894096000},"page":"599-611","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of maternal prepregnancy body mass index on neonatal outcomes following extremely preterm birth"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0467-9577","authenticated-orcid":false,"given":"Charlotte","family":"Girard","sequence":"first","affiliation":[{"name":"Obstetric, Perinatal, Paediatric and Life Course Epidemiology Team (OPPaLE), Center for Research in Epidemiology and StatisticS (CRESS) Institut National pour la Sant\u00e9 et la Recherche M\u00e9dicale (INSERM, French Institute for Health and Medical Research), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAe), Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9568-2969","authenticated-orcid":false,"given":"Jennifer","family":"Zeitlin","sequence":"additional","affiliation":[{"name":"Obstetric, Perinatal, Paediatric and Life Course Epidemiology Team (OPPaLE), Center for Research in Epidemiology and StatisticS (CRESS) Institut National pour la Sant\u00e9 et la Recherche M\u00e9dicale (INSERM, French Institute for Health and Medical Research), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAe), Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5890-2953","authenticated-orcid":false,"given":"Neil","family":"Marlow","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Elizabeth Garrett Anderson Institute for Women\u2019s Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4191-3781","authenticated-orcid":false,"given":"Mikael","family":"Norman","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science, Intervention, and Technology  Stockholm Sweden"},{"name":"Division of Pediatrics, Karolinska Institutet, Department of Clinical Science Intervention, and Technology  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2194-2374","authenticated-orcid":false,"given":"Fredrik","family":"Serenius","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-8176","authenticated-orcid":false,"given":"Elizabeth S.","family":"Draper","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-7881","authenticated-orcid":false,"given":"Samantha","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Benhammou","sequence":"additional","affiliation":[{"name":"Obstetric, Perinatal, Paediatric and Life Course Epidemiology Team (OPPaLE), Center for Research in Epidemiology and StatisticS (CRESS) Institut National pour la Sant\u00e9 et la Recherche M\u00e9dicale (INSERM, French Institute for Health and Medical Research), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAe), Paris Cit\u00e9 University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5765-2630","authenticated-orcid":false,"given":"Karin","family":"K\u00e4ll\u00e9n","sequence":"additional","affiliation":[{"name":"Center of Reproductive Epidemiology Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1098-2119","authenticated-orcid":false,"given":"Stef","family":"van Buuren","sequence":"additional","affiliation":[{"name":"Netherlands Organisation for Applied Scientific Research  Leiden Netherlands"},{"name":"Department of Methodology &amp; 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