Overweight and Obesity Are Key Modifiable Risk Factors for Adverse Outcomes in Systemic Lupus Erythematosus Pregnancies
Bibliographic record
Abstract
Objectives To determine if overweight (25-29.9 kg/m2) or obese (≥30 kg/m2) baseline body mass index (BMI) conferred higher adverse pregnancy outcomes (APO) risk compared to BMI <25 kg/m2 in a prospective systemic lupus erythematosus (SLE) pregnancy cohort. Methods We enrolled pregnant SLE women at <17 weeks gestation at 5 Systemic Lupus International Collaborating Clinics centers in Canada and South Korea. We collected data on demographics, obstetrical history, SLE characteristics, baseline comorbidities, and APO at each of the 2nd trimester, 3rd trimester, and end-of-pregnancy (8-12 weeks) visits. APO included: (1) fetal death >20 weeks’ gestation, (2) neonatal death due to preterm birth and/or placental insufficiency, (3) preterm delivery or termination <36 weeks due to placental insufficiency, gestational hypertension, preeclampsia, and/or eclampsia, and (4) small for gestational age (<5th percentile). We assessed the proportion of APO across the different BMI groups. We conducted a multivariate analysis using the Korean BMI classification for pregnancies from Asian mothers [obese (BMI ≥25 kg/m2), overweight (BMI 23-24.9 kg/m2), and normal weight (BMI <23 kg/m2)]. Results We analyzed 80 completed pregnancies, with a mean maternal age of 33.9 years (standard deviation, SD 4.1) and BMI of 26.0 kg/m2 (SD 6.7). Almost half (40%) of pregnancies had a maternal BMI ≥25 kg/m2. Non-Hispanic Whites made up 40% of the pregnancies and more than half (56%) of pregnancies with a maternal BMI ≥30 kg/m2 (Table 1). Overall, APO occurred in 8 (10%) pregnancies. The proportion of APO was 19% [95% CI 0, 38%] in both the BMI 25-29.9 kg/m2 and BMI ≥30 kg/m2 groups and 4% (95% CI 1, 12%) in the BMI <25 kg/m2 group. In univariate analysis, there was more than a 5-fold increased risk of APO in pregnancies with maternal BMI ≥25 kg/m2 versus those with BMI <25 kg/m2 [odds ratio (OR) 5.31; 95% CI 1.00, 28.24]. In multivariate analysis, using the Korean BMI classification for all Asian mothers and adjusting for race and antiphospholipid antibody status, overweight and obese pregnancies had a substantially increased risk of APO compared to those with normal weight (OR 6.32; 95% CI 1.25, 32.0). Table 1. SLE Pregnancy Characteristics by Body Mass Index (BMI, kg/m 2 ) Conclusion Overweight and obese SLE women had higher APO risk compared to those with normal weight. High BMI may be a modifiable risk factor for APO in women with SLE. Supported by a CIORA grant
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".