Maternal Overweight and Obesity and the Risk of Congenital Anomalies

Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom NE2 4HH.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 03/2009; 301(6):636-50. DOI: 10.1001/jama.2009.113
Source: PubMed


Evidence suggests an association between maternal obesity and some congenital anomalies.
To assess current evidence of the association between maternal overweight, maternal obesity, and congenital anomaly.
MEDLINE, EMBASE, CINAHL, and Scopus (January 1966 through May 2008) were searched for English-language studies using a list of keywords. Reference lists from relevant review articles were also searched.
Observational studies with an estimate of prepregnancy or early pregnancy weight or body mass index (BMI) and data on congenital anomalies were considered. Of 1944 potential articles, 39 were included in the systematic review and 18 in the meta-analysis. Data Extraction and Synthesis Information was extracted on study design, quality, participants, congenital anomaly groups and subtypes, and risk estimates. Pooled odds ratios (ORs) comparing risk among overweight, obese, and recommended-weight mothers (defined by BMI) were determined for congenital anomaly groups and subtypes for which at least 150 cases had been reported in the literature.
Pooled ORs for overweight and obesity were calculated for 16 and 15 anomaly groups or subtypes, respectively. Compared with mothers of recommended BMI, obese mothers were at increased odds of pregnancies affected by neural tube defects (OR, 1.87; 95% confidence interval [CI], 1.62-2.15), spina bifida (OR, 2.24; 95% CI, 1.86-2.69), cardiovascular anomalies (OR, 1.30; 95% CI, 1.12-1.51), septal anomalies (OR, 1.20; 95% CI, 1.09-1.31), cleft palate (OR, 1.23; 95% CI, 1.03-1.47), cleft lip and palate (OR, 1.20; 95% CI, 1.03-1.40), anorectal atresia (OR, 1.48; 95% CI, 1.12-1.97), hydrocephaly (OR, 1.68; 95% CI, 1.19-2.36), and limb reduction anomalies (OR, 1.34; 95% CI, 1.03-1.73). The risk of gastroschisis among obese mothers was significantly reduced (OR, 0.17; 95% CI, 0.10-0.30).
Maternal obesity is associated with an increased risk of a range of structural anomalies, although the absolute increase is likely to be small. Further studies are needed to confirm whether maternal overweight is also implicated.

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    • "It is clear that the heart is significantly affected by maternal obesity with a well-established link between maternal obesity and CVD in offspring in both human and animal studies [4]. Offspring of obese and overweight mothers have a significantly increased risk of cardiovascular anomalies [5], and obesity during pregnancy has been linked to increased risk for CVD in adult human offspring [6]. However there is currently a limited mechanistic understanding of how maternal obesity causes foetal programming of CVD; altered sympathetic nervous activity and adrenoceptor expression, have been reported in offspring of obese dams [7]. "
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    Nutrition Metabolism and Cardiovascular Diseases 06/2015; 25(9). DOI:10.1016/j.numecd.2015.05.011 · 3.32 Impact Factor
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    • "Obesity also has an adverse impact on pregnancy outcomes. It is associated with an increased chance of preeclampsia, miscarriage rates, gestational diabetes risk, birth complications, perinatal death, congenital abnormalities of the cardiovascular system, and neural tube defects [6] [7] [8]. Previous papers on obesity have reported gonadotropin resistance, diminished oocyte-embryo quality, and implantation failures in IVF patients [2] [3] [4] [5]. "
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