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Comment & Response
June 27, 2017

Maternal Obesity and Cerebral Palsy in Offspring—Reply

Author Affiliations
  • 1Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
  • 2Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
  • 3Department of Medicine, Karolinska Institutet, Stockholm, Sweden
JAMA. 2017;317(24):2550. doi:10.1001/jama.2017.5979

In Reply Mr Li and Dr Li raise 3 points. First, they note that the analyses did not adjust for important confounding factors including maternal diabetes and hypertension. Gestational diabetes and pregnancy-induced hypertensive diseases are not confounders of the association between early pregnancy BMI and cerebral palsy because they are generally regarded as consequences, not causes, of maternal obesity.1 Similarly, overweight and obesity increase risks of manifest (type 1 or type 2) diabetes and essential hypertension in a dose-response manner.2,3

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