Increasing Maternal Body Mass Index Is Associated With Fetal Defects

Abstract

IntroductionThe incidence of obesity is constantly rising and is developing into a relevant economic and public health concern. According to the World Health Organization (WHO) 1.4 billion people in the world suffered from obesity in 2008. Of these 0.3 billion were women including those of childbearing age. In pregnancy, obesity increases the risks both for the mother and fetus. Maternal risks are thromboembolism, gestational diabetes, preeclampsia, hypertension and urogenital infections (1-3). Moreover, an increased maternal body mass index (BMI) has been shown to be a risk factor for spontaneous abortion and intrauterine fetal death (2,4). A recent study demonstrated that obese women who suffered two or more abortions tended to have a higher incidence of euploid abortions (5). Regarding delivery, a higher rate of cesarean sections has been described in obese women with an increase in surgical and postoperative complications (3,6). Children of women with a high BMI are more likely to be delivered preterm with a subsequent need for neonatal intensive care treatment (7,8). In addition, maternal obesity is linked to high infant birth weight, subsequent complications during delivery and an increased incidence of children suffering from a metabolic syndrome in their later lives (9,10). However, the occurrence of congenital fetal anomalies has also been associated with obesity in pregnant women. A meta-analysis of 12 studies could confirm an association between maternal obesity and an increased risk of neural tube defects (11), whereas another meta-analysis of 18 studies showed an association between the incidence of fetal hydrocephaly, cardiovascular anomalies, cleft palate, anorectal atresia and limb reduction anomalies (12). Interestingly, the risk of gastroschisis was significantly reduced in obese mothers. On the other hand, congenital anomalies are a major risk factor for perinatal and infant death (13). Prenatal ultrasound scans are utilized to detect congenital malformations in pregnancy. The effect of maternal overweight and obesity on the sensitivity of ultrasound diagnostics has been reported previously. Aagaard-Tillery et al described that maternal obesity significantly decreased the likelihood of sonographic detection of common anomalies in 8555 pregnancies with available BMI (14). This would lead to the assumption that obese women not only tend to have a higher risk of having children with congenital anomalies but also suffer from lower detection rates which has implications on antenatal counseling in this group (15). The aim of this retrospective case-control study was to investigate the association between maternal BMI and con- AbstractObjectives: To test the hypothesis, that increasing maternal weight is directly related to the incidence of fetal anomalies, to rank anomalies according to their frequency and to establish detection rates for the various anomalies with increasing body mass index (BMI). Materials and Methods: Retrospective single center matched case control study, analysis of the associa...

A qualitative study exploring midwives' perceptions and knowledge of maternal obesity: Reflecting on their experiences of providing healthy eating and weight management advice to pregnant women

“…Obesity in pregnancy carries significant risks for both the mother and baby including increased risk of gestational diabetes, hypertension, caesarean delivery, and postoperative complications (Heslehurst et al, ; Scott‐Pillai, Spence, Cardwell, Hunter, & Holmes, ). This exerts increased demands on health care professionals due to these associated maternal (Arrowsmith, Wray, & Quenby, ; Denison, Price, Graham, Wild, & Listond, ) and fetal complications (Van Mackelenbergh, Marotte, Alkatout, von Kaisenberg, & Eckmann‐Scholz, ). Excessive Gestational Weight Gain (GWG) can incur equivalent health risks to obesity (Heslehurst et al, ); the consequences are considerable and are related to a host of adverse health effects, many of which can persist into future generations (Stupin & Arabin, ).…”