{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:14:29Z","timestamp":1790774069090,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,1,28]],"date-time":"2024-01-28T00:00:00Z","timestamp":1706400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Maternal obesity, a health condition increasingly prevalent worldwide, has been suggested to be associated with a higher risk of birth defects in offspring, whereas evidence from population\u2010based data from China was largely lacking. Additionally, the role of gestational diabetes in the association between maternal obesity and birth defects remains unclear. We aimed to investigate the association of maternal pre\u2010pregnancy overweight or obesity with any and different types of birth defects in offspring and the interaction between pre\u2010pregnancy overweight or obesity and gestational diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>We conducted a population\u2010based cohort study including 257\u2009107 singletons born between 2015 and 2021 in Longgang District, Shenzhen, China, using data from the Shenzhen Maternal and Child Health Management System. Poisson regression was conducted to estimate the associations of maternal pre\u2010pregnancy overweight or obesity, as well as the interaction between pre\u2010pregnancy overweight or obesity and gestational diabetes, with the risk of birth defects. Models were adjusted for maternal age at delivery, educational level, type of household registration, and gravidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Maternal pre\u2010pregnancy overweight was associated with a higher risk of any birth defect (risk ratio [RR] 1.21, 95% confidence interval [CI] 1.12 to 1.31) as well as of congenital malformations of the circulatory system (RR 1.26, 95% CI 1.12 to 1.41), eye\/ear\/face\/neck (RR 1.42, 95% CI 1.04 to 1.94), and musculoskeletal system (RR 1.21, 95% CI 1.01 to 1.44). Maternal pre\u2010pregnancy obesity was associated with a higher risk of any birth defect (RR 1.38, 95% CI 1.18 to 1.63) and congenital malformations of the circulatory system (RR 1.61, 95% CI 1.30 to 1.98). Infants born to overweight or obese mothers with gestational diabetes had a higher risk of congenital malformations of the circulatory system than infants born to overweight or obese mothers without gestational diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Maternal pre\u2010pregnancy overweight or obesity was associated with a higher risk of birth defects, particularly congenital malformations of the circulatory system, in offspring. Gestational diabetes interacts additively with pre\u2010pregnancy overweight or obesity on modifying the risk of congenital malformations of the circulatory system. The importance of improving weight management and assessment of glucose and metabolic functions was emphasized among women planning for pregnancy who are overweight or obese.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14786","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:33:05Z","timestamp":1706488385000},"page":"862-872","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Maternal pre\u2010pregnancy overweight or obesity and risk of birth defects in offspring: Population\u2010based cohort study"],"prefix":"10.1111","volume":"103","author":[{"given":"Weiying","family":"Liu","sequence":"first","affiliation":[{"name":"Longgang District Maternity &amp; Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College)  Shenzhen China"},{"name":"Department of Epidemiology, School of Public Health (Shenzhen) Sun Yat\u2010sen University  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luzhong","family":"Ren","sequence":"additional","affiliation":[{"name":"Longgang District Maternity &amp; Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College)  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4911-3543","authenticated-orcid":false,"given":"Ruoqing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health (Shenzhen) Sun Yat\u2010sen University  Shenzhen China"},{"name":"Institute of Environmental Medicine Karolinska Institute  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,28]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"WHO.Obesity and overweight.2021https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/obesity\u2010and\u2010overweight"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00798-4"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)30217-0"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14091895"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.01.017"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1589"},{"key":"e_1_2_14_9_1","unstructured":"WHO.Newborn mortality.2021https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/levels\u2010and\u2010trends\u2010in\u2010child\u2010mortality\u2010report\u20102021"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2249"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-020-04679-0"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12084"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.011541"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.021"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2563"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.10.050"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00045-0"},{"issue":"176","key":"e_1_2_14_18_1","first-page":"e1","article-title":"Specific birth defects in pregnancies of women with diabetes: National Birth Defects Prevention Study, 1997\u20132011","volume":"222","author":"Tinker SC","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-0261"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20725"},{"key":"e_1_2_14_21_1","first-page":"83","article-title":"Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults\u2014study on optimal cut\u2010off points of body mass index and waist circumference in Chinese adults","volume":"15","author":"Zhou BF","year":"2002","journal-title":"Biomed Environ Sci"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081369"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002504"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2010.01186.x"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.00378"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.21037\/tp-23-197"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0111056"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/155.2.176"},{"key":"e_1_2_14_29_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0138549","article-title":"Prepregnancy obesity and risks of stillbirth","volume":"10","author":"Shankar K","year":"2015","journal-title":"PLoS One"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2022.08.016"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2009.28865"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03100-w"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.33694"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.03.026"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20190266"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13020331"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.611929"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20090640"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2018.09.004"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu5114760"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2021.09.005"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T15:03:48Z","timestamp":1744297428000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,28]]},"references-count":40,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/aogs.14786"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14786","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,28]]},"assertion":[{"value":"2023-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}