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Objective Preterm birth (PTB) is one of the leading causes of infant and neonatal mortality. Prepregnancy body mass index (BMI; kg/m2) has been linked to PTB but the evidence of this association by weight gain during pregnancy, race, and ethnicity is limited. This study aimed to assess the association between maternal prepregnancy BMI and PTB stratified by weight gain during pregnancy, race, and ethnicity. Study Design The U.S. natality data from 2017 to 2021 were used. In this analysis, we included mothers who had a live singleton birth and available data for prepregnancy BMI, gestational age at birth, weight gain during pregnancy, race, and ethnicity. Logistic regression models were used to assess the association between prepregnancy BMI categories and PTB stratified by weight gain during pregnancy, race, and ethnicity. Results A total of 17,311,509 singleton live births were included of which 1,393,889 (8.05 %) were PTBs. After adjusting for confounders, compared with normal prepregnancy BMI mothers (18.5–24.9), those with underweight BMI (<18.5) were at increased odds of PTB regardless of weight gain during pregnancy, race, and ethnicity. However, for mothers with a prepregnancy BMI above the normal weight (≥25), the association between prepregnancy BMI and PTB differs by weight gain during pregnancy, race, and ethnicity. Asian mothers with obesity II (35.0–39.9) had 93% (odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.62–2.30) increased odds of PTB for weight gain during pregnancy of 31 to 40 pounds. Their White, Hispanic, and Black counterparts experienced lower odds of PTB for similar weight gain during pregnancy (White: OR = 1.56, 95% CI: 1.51–1.60; Hispanic: OR = 1.48, 95% CI: 1.41, 1.54; and Black: OR = 1.22, 95% CI: 1.17–1.27). Conclusion Mothers with underweight BMI were at increased risk of PTB regardless of weight gain during pregnancy, race, and ethnicity. However, the association between high prepregnancy BMI and PTB varied by weight gain during pregnancy, race, and ethnicity. Key Points
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Stroke is a leading cause of death and disability worldwide. It is a serious disease caused by a disruption of blood flow in the brain resulting from either blockage of blood flow to the brain (ischemic stroke) or sudden bleeding in the brain (hemorrhagic stroke). Stroke survivors experience more sleep disorders than the general population. Sleep disorders could also increase the risk of stroke even in individuals who have no history of stroke. Obstructive sleep apnea and insomnia are the most common sleep disorders associated with increased risk of stroke. Long sleep duration (≥9 h/day) and circadian rhythm changes have also been linked to an increased risk of stroke. This chapter summarizes the current evidence on the relationship between sleep disorders and stroke. © 2025 Springer Nature Switzerland AG.
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