{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:19:01Z","timestamp":1777861141780,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["HD106203"],"award-info":[{"award-number":["HD106203"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We investigated the associations of grandmaternal early pregnancy BMI with grand\u2010offspring risks of birth asphyxia\u2010related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a nationwide three\u2010generation Swedish cohort, we estimated adjusted relative risks (RRs) of Apgar score 0\u20133 at 5\u2009min and neonatal seizures for categories of grandmaternal BMI among 315,461 maternal and 203,522 paternal singleton live\u2010born grand\u2010offspring. To address unmeasured confounding by shared familial factors, we used the parental full sisters' BMI as a negative control exposure. In the maternal line, we assessed whether associations with grandmaternal obesity were mediated through maternal obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with normal maternal grandmaternal BMI, RRs (95% CI) of low Apgar score were, respectively, 1.29 (1.06, 1.57) and 1.53 (1.03, 2.28) for overweight (BMI 25.0 to 29.9) and obesity (BMI \u2265\u200930.0). For neonatal seizures, the corresponding RRs (95% CI) were 1.32 (1.05, 1.66) and 1.81 (1.17, 2.79). Maternal sisters' BMI was unrelated to both outcomes. Maternal obesity mediated &lt;\u200925% of the associations with maternal grandmaternal obesity. Paternal grandmaternal obesity was related to an increased risk of neonatal seizures; paternal sisters' BMI was unrelated to this outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Grandmaternal overweight and obesity are related to increased risks of severe birth asphyxia\u2010related complications in grand\u2010offspring, independent of unmeasured shared familial factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oby.70046","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T09:25:22Z","timestamp":1758187522000},"page":"2398-2405","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Grandmaternal Obesity and Risks of Birth Asphyxia\u2010Related Complications in Grand\u2010Offspring: A\u00a0Countrywide Three\u2010Generation Study"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3937-5574","authenticated-orcid":false,"given":"Eduardo","family":"Villamor","sequence":"first","affiliation":[{"name":"Department of Epidemiology School of Public Health, University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda K.","family":"Miglin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology School of Public Health, University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Cnattingius","sequence":"additional","affiliation":[{"name":"Section of Clinical Epidemiology, Department of Medicine Solna Karolinska Institutet  Stockholm 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