Int J Obes (Lond). 2025 Nov 15. doi: 10.1038/s41366-025-01955-7. Online ahead of print.
ABSTRACT
BACKGROUND: The global increase in maternal obesity has raised concerns regarding its potential impact on offspring neurodevelopment. This study investigated the association between maternal pre-pregnancy body mass index (BMI) and the risk of neurodevelopmental disorders in offspring using a large-scale national cohort in South Korea.
METHODS: We conducted a retrospective cohort study using data from the Korean National Health Information Database merged with the National Health Screening Program data. Maternal BMI, measured within three years prior to delivery, was categorized based on the Asia-Pacific guidelines. Neurodevelopmental disorders, including epilepsy, cerebral palsy, intellectual disability, autism spectrum disorder, and attention-deficit/hyperactivity disorder, were identified using diagnostic codes from the International Classification of Diseases, Tenth Revision (ICD-10) up to five years of age. Multivariable Poisson and Cox regression models were used to estimate the relative risks and hazard ratios, adjusting for neonatal and maternal covariates.
RESULTS: This study analyzed a cohort of 2,285,943 live births in South Korea (January 1, 2014-December 31, 2021) to assess the association between maternal pre-pregnancy BMI and neurodevelopmental disorders in offspring. After excluding neonates lacking complete medical records or follow-up data, 779,091 neonates were included in the study. Maternal obesity (BMI ≥ 30.0) was independently associated with an elevated risk of epilepsy (adjusted hazard ratio 1.13; 95% CI, 1.08-1.18) and intellectual disability (aHR 1.37; 95% CI, 1.12-1.68), following adjustment for neonatal and maternal covariates. Maternal underweight status (BMI < 18.5) was not significantly associated with neurodevelopmental outcomes. Elevated maternal BMI prior to conception was independently associated with an increased risk of epilepsy and intellectual disability in offspring.
CONCLUSIONS: The results underscore the importance of preconception weight management and support public health strategies to reduce neurodevelopmental disorders in children of mothers with overweight or obesity.
PMID:41241663 | DOI:10.1038/s41366-025-01955-7
