{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:35:52Z","timestamp":1790703352554,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T00:00:00Z","timestamp":1571270400000},"content-version":"am","delay-in-days":365,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T00:00:00Z","timestamp":1539734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001665","name":"Agence Nationale de la Recherche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007917","name":"Agricultural Research Service","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007917","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Maternal obesity is increasing. There is growing evidence of its effect on severe maternal morbidity. We assessed prepregnancy obesity as an independent risk factor for severe maternal morbidity by timing and cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We designed a case\u2010control analysis within the\n                      <jats:styled-content style=\"fixed-case\">EPIMOMS<\/jats:styled-content>\n                      prospective population\u2010based study conducted in six French regions in 2012\u20102013 (182\u00a0309 women who delivered at \u226522\u00a0weeks). Cases were all women who experienced severe maternal morbidity during pregnancy to 42\u00a0days postpartum as per a multicriteria definition derived by national expert consensus (n\u00a0=\u00a02540, severe maternal morbidity prevalence 1.4%). Controls were randomly selected from the same health centres (n\u00a0=\u00a03651). The association between obesity and severe maternal morbidity was assessed from fitting multivariable logistic regression models: overall, by timing (antepartum and intrapartum\/ postpartum), and by cause.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Prepregnancy obesity was associated with overall severe maternal morbidity (adjusted odds ratio [\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      ] 1.34, 95% confidence interval [\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ] 1.14, 1.59) and antepartum severe maternal morbidity (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      2.07, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.61, 2.65), but not with intra\/postpartum severe maternal morbidity (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      1.15, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.96, 1.38). Among antepartum severe maternal morbidity, severe hypertensive disorders were most strongly associated with obesity (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      2.50, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.85, 3.40) but the risk of antepartum severe maternal morbidity due to other causes was also increased among obese women (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      1.64, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.13, 2.37). Obesity was not associated with severe postpartum haemorrhage (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      1.12, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.92, 1.37).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obesity is associated with an increased risk of antepartum, but not intra\/ postpartum, severe maternal morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ppe.12522","type":"journal-article","created":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T05:44:53Z","timestamp":1539755093000},"page":"7-16","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Associations between maternal obesity and severe maternal morbidity: Findings from the French\n                    <scp>EPIMOMS<\/scp>\n                    population\u2010based study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7457-6745","authenticated-orcid":false,"given":"Ayesha","family":"Siddiqui","sequence":"first","affiliation":[{"name":"National Institute for Health and Medical Research (INSERM) Unit 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOP\u00e9) Center for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 DHU Risks in Pregnancy Paris Descartes University  Paris France"},{"name":"Department of Family Medicine and Community Health Icahn School of Medicine at Mount Sinai  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie","family":"Azria","sequence":"additional","affiliation":[{"name":"National Institute for Health and Medical Research (INSERM) Unit 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOP\u00e9) Center for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 DHU Risks in Pregnancy Paris Descartes University  Paris France"},{"name":"Maternity Unit Notre Dame de Bon Secours \u2010Paris Saint Joseph Hospital\/University Hospital Department (DHU) Risks in Pregnancy Paris Descartes University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Howell","sequence":"additional","affiliation":[{"name":"Blavatnik Family Women's Health Research Institute Icahn School of Medicine at Mount Sinai  New York New York"},{"name":"Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai  New York New York"},{"name":"Department of Obstetrics, Gynecology, and Reproductive Science Icahn School of Medicine at Mount Sinai  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6561-3321","authenticated-orcid":false,"given":"Catherine","family":"Deneux\u2010Tharaux","sequence":"additional","affiliation":[{"name":"National Institute for Health and Medical Research (INSERM) Unit 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOP\u00e9) Center for Epidemiology and Statistics Sorbonne Paris Cit\u00e9 DHU Risks in Pregnancy Paris Descartes University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the EPIMOMS Study 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