Effect of Maternal Obesity on the Ultrasound Detection of Anomalous Fetuses

Dashe, Jodi S.; McIntire, Donald D.; Twickler, Diane M.

doi:10.1097/aog.0b013e3181a1d2f5

Cited by 222 publications

(71 citation statements)

References 7 publications

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“…In the three obesity classes - class I (BMI 30-34.9), class II (BMI 35-39.9), and class III (BMI ≥40) - the detection rates were 48, 42, and 28%, respectively. The detection rate among obese women was thus slightly higher than in the present study [15]. …”

Section: Discussioncontrasting

confidence: 51%

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Maternal Obesity and Detection Rate of Fetal Structural Anomalies

2013

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Objective: To estimate the effects of maternal body mass index (BMI) on the sensitivity of detecting fetal anomalies by a routine ultrasound performed either in the first or in the second trimester. Methods: Unselected pregnant women (n = 19,140) were divided into four BMI groups: underweight (<18.5), normal weight (18.5-24.9, reference group), overweight (25.0-29.9), and obese (≥30.0). Fetal anomaly diagnoses were grouped according to their likely clinical consequences as suggested by the Royal College of Obstetricians and Gynaecologists. Minor anomalies were excluded. The detection rate of fetal anomalies in each BMI group was calculated and compared. Results: The prevalence of infants with structural anomalies in the study population was 4% and the prevalence of material obesity was 10%. The detection rates of fetal structural anomalies were 26% for normal-weight, 29% for overweight (odds ratio (OR) 1.15, 95% confidence interval (CI) 0.68-1.95), and 19% for obese women (OR 0.67, 95% CI 0.29-1.52). The detection rate of anomalies with long-term handicap was lower in the obese group (27.3%; OR 0.44, 95% CI 0.11-1.79) compared to normal-weight women (46.3%). Conclusion: The detection rate of fetal anomalies seems to be lower for obese women, but these findings need to be further investigated.

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Section: Discussioncontrasting

confidence: 51%

“…The effect of maternal obesity on ultrasound detection of fetal anomalies has been studied by Aagaard-Tillery et al [14 ]and Dashe et al [15] in two low-risk US populations (n = 8,555 and n = 10,112, respectively). Both studies indicate a lower detection rate of anomalous fetuses among obese women compared to women with a normal BMI.…”

Section: Introductionmentioning

confidence: 99%

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

2013

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“…In contrast, the sensitivity was lower in women with increased body weight (93.6%), which highlights an association of maternal body weight with the detectability of fetal malformations. Similar results were published in a study that investigated the sensitivity of prenatal ultrasound between 18 and 24 weeks of gestation in 1098 cases (25). The authors described sensitivities of 97% in women with a normal BMI that decreased to 75%-88% among obese women.…”

Section: Discussionsupporting

confidence: 72%

Increasing Maternal Body Mass Index Is Associated With Fetal Defects

Mackelenbergh¹,

Marotte²,

Alkatout³

et al. 2016

IJWHR

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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...

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“…Wong et al [24] found that the anomaly detection rate in pregestational diabetic patients was lower than the nondiabetic population (30% vs 73%) and attributed this finding to the significantly higher BMI of the diabetic patients (29 vs 23 kg/m 2 ). Dashe et al [25] published their experience at a large tertiary care facility with regard to anomaly detection and maternal BMI. They reported decreased detection with increased BMI.…”

Section: Detection Of Fetal Anomaliesmentioning

confidence: 99%

Sonographic Evaluation and the Pregnancy Complicated by Diabetes

McNamara

Odibo

2010

Curr Diab Rep

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Sonography is a fundamental tool in the management of pregnancies affected by maternal diabetes. Purposeful use of ultrasound in each trimester provides an invaluable amount of information about the developing fetus including gestational age and growth patterns, anatomical structure and function, assessment of fetal well-being, and prediction of adverse outcome. There are great ongoing research efforts in this field of prenatal diagnosis and management, yet even more are needed.

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Effect of Maternal Obesity on the Ultrasound Detection of Anomalous Fetuses

Cited by 222 publications

References 7 publications

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

Maternal Obesity and Detection Rate of Fetal Structural Anomalies

Increasing Maternal Body Mass Index Is Associated With Fetal Defects

Sonographic Evaluation and the Pregnancy Complicated by Diabetes

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