Grandmaternal Obesity and Risks of Birth Asphyxia‐Related Complications in Grand‐Offspring: A Countrywide Three‐Generation Study
Authors' conclusion
Grandmaternal overweight and obesity are related to increased risks of severe birth asphyxia-related complications in grand-offspring, independent of unmeasured shared familial factors.
Study context
- Population
- Singleton live-born grand-offspring in a nationwide three-generation Swedish cohort: 315,461 maternal and 203,522 paternal grand-offspring
- Exposure
- Grandmaternal early pregnancy BMI categories vs normal BMI
- Outcome
- Apgar score 0-3 at 5 min and neonatal seizures
Methodological detailsnationwide, three-generation, negative control exposure (parental full sisters' BMI), mediation analysis
- Nationwide
- Three-generation
- Negative control exposure (parental full sisters' BMI)
- Mediation analysis
Main finding
As reported in the abstract
Low Apgar score (0-3 at 5 min), maternal line
Each group vs normal BMIAdjusted relative risk (95% CI)
Overweight
1.29(1.06–1.57)
Obesity
1.53(1.03–2.28)
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted RR (95% CI) | |
|---|---|---|
| Neonatal seizures, maternal lineOverweightvs Normal BMI | 1.32 (1.05–1.66) | |
| Neonatal seizures, maternal lineObesityvs Normal BMI | 1.81 (1.17–2.79) | |
| 0.20.5125Adjusted relative risk (log scale) |
Negative control and mediation
- Maternal obesity mediated share of associations with maternal grandmaternal obesity
- < 25%
- Maternal sisters' BMI unrelated to both outcomes
- Paternal grandmaternal obesity related to increased risk of neonatal seizures; paternal sisters' BMI unrelated
Original publication
Grandmaternal Obesity and Risks of Birth Asphyxia‐Related Complications in Grand‐Offspring: A Countrywide Three‐Generation Study. Obesity (Silver Spring). Published 18 September 2025. doi:10.
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