Maternal obesity and long-term neuropsychiatric morbidity of the offspring



To evaluate the long-term pediatric neuropsychiatric morbidity of children born to obese patients.

Study design

A population-based cohort analysis was performed comparing all deliveries of obese (maternal pre-pregnancy body mass index of 30 kg/m2 or more) and non-obese patients between 1991 and 2014 at a single tertiary medical center. Hospitalizations of the offspring up to the age of 18 years involving neuropsychiatric morbidities were evaluated according to a pre-defined set of ICD-9 codes, including autistic, eating, sleeping and movement disorders, cerebral palsy, developmental disorders, and more. A Kaplan–Meier survival curve was used to compare cumulative hospitalization rate in exposed and unexposed offspring. A Cox regression model was used to control for confounders.


During the study period, 242,342 deliveries met the inclusion criteria. Of them, 3290 were children of obese mothers. Hospitalizations involving neuropsychiatric morbidities were higher in children born to obese mothers compared with those born to non-obese mothers (3.95% vs. 3.10%, p < 0.01). Specifically, offspring of obese mothers had higher rates of autism spectrum disorders and psychiatric disorders. The Kaplan–Meier survival curve demonstrated a significantly higher cumulative incidence of neuropsychiatric-related hospitalizations in the obese group (Fig. 1, log rank p < 0.05). Using a cox proportional hazard model, controlling for maternal age, preterm labor, maternal diabetes, hypertensive disorders of pregnancy, and birthweight, maternal obesity was found to be independently associated with long-term neuropsychiatric morbidity of the offspring (adjusted HR 1.24, 95% CI 1.04–1.47, p < 0.05).


Maternal obesity is an independent risk factor for long-term neuropsychiatric morbidity of the offspring.

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Fig. 1


  1. 1.

    Willis K, Lieberman N, Sheiner E (2015) Pregnancy and neonatal outcome after bariatric surgery. Best Pract Res Clin Obstet Gynaecol 29(1):133–144

    Article  Google Scholar 

  2. 2.

    Mission JF, Marshall NE, Caughey AB (2015) Pregnancy risks associated with obesity. Obstet Gynecol Clin North Am 42(2):335–353

    Article  Google Scholar 

  3. 3.

    Burstein E, Levy A, Mazor M, Wiznitzer A, Sheiner E (2008) Pregnancy outcome among obese women: a prospective study. Am J Perinatol 25(9):561–566

    Article  Google Scholar 

  4. 4.

    Sheiner E, Levy A, Menes TS, Silverberg D, Katz M, Mazor M (2004) Maternal obesity as an independent risk factor for caesarean delivery. Paediatr Perinat Epidemiol 18(3):196–201

    Article  Google Scholar 

  5. 5.

    Gilead R, Yaniv Salem S, Sergienko R, Sheiner E (2012) Maternal, “isolated” obesity and obstetric complications. J Matern Fetal Neonatal Med 25(12):2579–2582

    Article  Google Scholar 

  6. 6.

    Yaniv-Salem S, Shoham-Vardi I, Kessous R, Pariente G, Sergienko R, Sheiner E (2016) Obesity in pregnancy: what’s next? Long-term cardiovascular morbidity in a follow-up period of more than a decade. J Matern Fetal Neonatal Med 29(4):619–623

    CAS  Article  Google Scholar 

  7. 7.

    Sasson I, Beharier O, Sergienko R, Szaingurten-Solodkin I, Kessous R, Belfair NJ et al (2016) Obesity during pregnancy and long-term risk for ophthalmic morbidity—a population-based study with a follow-up of more than a decade. J Matern Fetal Neonatal Med 29(18):2924–2928

    PubMed  Google Scholar 

  8. 8.

    Kessous R, Davidson E, Meirovitz M, Sergienko R, Sheiner E (2017) Prepregnancy obesity: a risk factor for future development of ovarian and breast cancer. Eur J Cancer Prev 26(2):151–155

    Article  Google Scholar 

  9. 9.

    Marchi J, Berg M, Dencker A, Olander E, Begley C (2015) Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev 16(8):621–638

    CAS  Article  Google Scholar 

  10. 10.

    Ovesen P, Rasmussen S, Kesmodel U (2011) Effect of prepregnancy maternal overweight and obesity on pregnancy outcome. Obstet Gynecol 118(2 Pt 1):305–312

    Article  Google Scholar 

  11. 11.

    Kleitman V, Feldman R, Walfisch A, Toledano R, Sheiner E (2016) Recurrent shoulder dystocia: is it predictable? Arch Gynecol Obstet 294(6):1161–1166

    Article  Google Scholar 

  12. 12.

    Okby R, Sheiner E (2012) Risk factors for neonatal brachial plexus paralysis. Arch Gynecol Obstet 286(2):333–336

    Article  Google Scholar 

  13. 13.

    Doherty DA, Magann EF, Francis J, Morrison JC, Newnham JP (2006) Pre-pregnancy body mass index and pregnancy outcomes. Int J Gynaecol Obstet 95(3):242–247

    CAS  Article  Google Scholar 

  14. 14.

    Mitanchez D, Chavatte-Palmer P (2018) Review shows that maternal obesity induces serious adverse neonatal effects and is associated with childhood obesity in their offspring. Acta Paediatr 107(7):1156–1165

    Article  Google Scholar 

  15. 15.

    Galliano D, Bellver J (2013) Female obesity: short- and long-term consequences on the offspring. Gynecol Endocrinol 29(7):626–631

    Article  Google Scholar 

  16. 16.

    Contu L, Hawkes C (2017) A review of the impact of maternal obesity on the cognitive function and mental health of the offspring. Int J Mol Sci 18(5):1093

    Article  Google Scholar 

  17. 17.

    Edlow AG (2017) Maternal obesity and neurodevelopmental and psychiatric disorders in offspring. Prenat Diagn 37(1):95

    Article  Google Scholar 

  18. 18.

    Sanchez CE, Barry C, Sabhlok A, Russell K, Majors A, Kollins SH et al (2018) Maternal pre-pregnancy obesity and child neurodevelopmental outcomes: a meta-analysis. Obes Rev 19(4):464

    CAS  Article  Google Scholar 

  19. 19.

    Wang Y, Tang S, Xu S, Weng S, Liu Z (2016) Maternal body mass index and risk of autism spectrum disorders in offspring: a meta-analysis. Sci Rep 6:34248

    CAS  Article  Google Scholar 

  20. 20.

    Krakowiak P, Walker CK, Bremer AA, Baker AS, Ozonoff S, Hansen RL et al (2012) Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics 129(5):e1121

    Article  Google Scholar 

  21. 21.

    Getz KD, Anderka MT, Werler MM, Jick SS (2016) Maternal pre-pregnancy body mass index and autism spectrum disorder among offspring: a population-based case–control study. Paediatr Perinat Epidemiol 30(5):479–487

    Article  Google Scholar 

  22. 22.

    Andersen CH, Thomsen PH, Nohr EA, Lemcke S (2018) Maternal body mass index before pregnancy as a risk factor for ADHD and autism in children. Eur Child Adolesc Psychiatry 27(2):139–148

    Article  Google Scholar 

  23. 23.

    Khandaker GM, Dibben CRM, Jones PB (2012) Does maternal body mass index during pregnancy influence risk of schizophrenia in the adult offspring? Obes Rev 13(6):518

    CAS  Article  Google Scholar 

  24. 24.

    Kong LH, Norstedt G, Schalling M, Gissler M, Lavebratt C (2018) The risk of offspring psychiatric disorders in the setting of maternal obesity and diabetes. Pediatrics.

    Article  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Schaefer CA, Brown AS, Wyatt RJ, Kline J, Begg MD, Bresnahan MA et al (2000) Maternal prepregnant body mass and risk of schizophrenia in adult offspring. Schizophr Bull 26(2):275–286

    CAS  Article  Google Scholar 

  26. 26.

    Robinson M, Zubrick SR, Pennell CE, Van Lieshout RJ, Jacoby P, Beilin LJ et al (2013) Pre-pregnancy maternal overweight and obesity increase the risk for affective disorders in offspring. J Dev Orig Health Dis 4(1):42–48

    CAS  Article  Google Scholar 

  27. 27.

    Sullivan EL, Riper KM, Lockard R, Valleau JC (2015) Maternal high-fat diet programming of the neuroendocrine system and behavior. Horm Behav 76:153–161

    CAS  Article  Google Scholar 

  28. 28.

    Perng W, Gillman MW, Mantzoros CS, Oken E (2014) A prospective study of maternal prenatal weight and offspring cardiometabolic health in midchildhood. Ann Epidemiol 24(11):800.e1

    Article  Google Scholar 

  29. 29.

    Ashwood P, Kwong C, Hansen R, Hertz-Picciotto I, Croen L, Krakowiak P et al (2008) Brief report: plasma leptin levels are elevated in autism: association with early onset phenotype? J Autism Dev Disord 38(1):169–175

    Article  Google Scholar 

  30. 30.

    van der Burg JW, Sen S, Chomitz V, Seidell J, Leviton A, Dammann O (2016) The role of systemic inflammation linking maternal BMI to neurodevelopment in children. Pediatr Res 79(1):3–12

    Article  Google Scholar 

  31. 31.

    Li YM, Ou JJ, Liu L, Zhang D, Zhao JP, Tang SY (2016) Association between maternal obesity and autism spectrum disorder in offspring: a meta-analysis. J Autism Dev Disord 46(1):95–102

    Article  Google Scholar 

  32. 32.

    Connolly N, Anixt J, Manning P, Ping-I Lin D, Marsolo KA, Bowers K (2016) Maternal metabolic risk factors for autism spectrum disorder—an analysis of electronic medical records and linked birth data. Autism Res 9(8):829

    Article  Google Scholar 

  33. 33.

    Maher G, O’Keeffe G, Kearney P, Kenny LC, Dinan T, Mattsson M et al (2018) Association of hypertensive disorders of pregnancy with risk of neurodevelopmental disorders in offspring a systematic review and meta-analysis. JAMA Psychiatry 75(8):809–819

    Article  Google Scholar 

  34. 34.

    Sheiner E, Shoham-Vardi I, Weitzman D, Gohar J, Carmi R (1998) Decisions regarding pregnancy termination among Bedouin couples referred to third level ultrasound clinic. Eur J Obstet Gynecol Reprod Biol 76(2):141–146

    CAS  Article  Google Scholar 

  35. 35.

    Abu-Ghanem S, Sheiner E, Sherf M, Wiznitzer A, Sergienko R, Shoham-Vardi I (2012) Lack of prenatal care in a traditional community: trends and perinatal outcomes. Arch Gynecol Obstet 285(5):1237–1242

    Article  Google Scholar 

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This study was conducted as part of the requirements for graduation from the Medical School of the Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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ZFN wrote the first draft of the manuscript. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript.

Corresponding author

Correspondence to Gil Gutvirtz.

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Neuhaus, Z.F., Gutvirtz, G., Pariente, G. et al. Maternal obesity and long-term neuropsychiatric morbidity of the offspring. Arch Gynecol Obstet 301, 143–149 (2020).

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  • Follow-up
  • Obesity
  • Long term
  • Neurological disease
  • Pediatric hospitalization
  • Pregnancy