Literature DB >> 22900903

Impact of maternal body mass index on the antenatal detection of congenital anomalies.

K E Best1, P W G Tennant, R Bell, J Rankin.   

Abstract

OBJECTIVE: To investigate the association between maternal body mass index (BMI) and antenatal ultrasound detection of congenital anomalies.
DESIGN: Population-based register study.
SETTING: North of England (UK). POPULATION: All pregnancies (n = 3096) associated with a congenital anomaly notified to the Northern Congenital Abnormality Survey (NorCAS) during 2006-2009. Cases with chromosomal and teratogenic anomalies (n = 611) or without information on antenatal scanning (n = 4) were excluded.
METHODS: Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for antenatal detection according to maternal BMI categories were estimated using logistic regression. MAIN OUTCOME MEASURES: For all anomalies combined, cases were defined as 'detected' if any congenital anomaly was suspected antenatally. Organ system-specific anomalies were defined as detected if an anomaly of the correct system was suspected.
RESULTS: Antenatal detection of any anomaly occurred in 1146 of 2483 (46.2%) cases with normal karyotype. The odds of detection were significantly decreased in obese (BMI ≥ 30 kg/m(2)) women compared with women of recommended BMI (18.5-24.9 kg/m(2); aOR, 0.77; 95% CI, 0.60-0.99; P = 0.046). Cardiovascular system anomalies were suspected antenatally in 109 of 945 (11.5%) cases. The odds of detecting a cardiovascular anomaly were significantly greater in underweight women (BMI < 18.5 kg/m(2)) than in women of recommended BMI (aOR, 2.95; 95% CI, 1.13-7.70; P = 0.027). There was no association between BMI and detection in any other organ system or between BMI and termination of pregnancy for fetal anomaly.
CONCLUSIONS: Antenatal ultrasound detection of a congenital anomaly is decreased in obese pregnant women. This has implications for the scanning and counselling of obese women.
© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

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Mesh:

Year:  2012        PMID: 22900903     DOI: 10.1111/j.1471-0528.2012.03462.x

Source DB:  PubMed          Journal:  BJOG        ISSN: 1470-0328            Impact factor:   6.531


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