Maternal obesity and metabolic disorders associate with congenital heart defects in the offspring: a systematic review

Abstract

Congenital heart defects (CHDs) are the most common congenital malformation and will, in severe cases, have a serious impact on neonatal mortality and morbidity. The aetiology of CHDs is complex. Large cohort studies have reported an association between increased risk of CHDs in the offspring and individual maternal metabolic disorders such as diabetes, hypertension, preeclampsia, and obesity. All conditions that can be related to insulin resistance and possibly metabolic syndrome (MetS). The aim of this review is to evaluate the existing evidence on the association between maternal metabolic disorders, defined as obesity, diabetes, hypertension, preeclampsia, dyslipidaemia, and MetS, or combinations thereof and CHDs in the offspring. A literature search was performed using PubMed and Embase databases. Of the 2,076 potentially relevant identified studies, 30 qualified for inclusion. Only one study dealt with the combination of more than one maternal metabolic condition as risk factor for CHDs in the offspring. All other studies investigated the individual metabolic disorders and their association with CHDs. Some disorders (chronic hypertension, gestational diabetes, and obesity) increased risk of CHDs marginally whereas pregestational diabetes and early-onset preeclampsia were highly associated with CHDs. Future studies on the combination of several metabolic disorders in the same pregnancy and their association with CHDs are needed.

Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review

“…Macrosomic infants weigh in excess of 4.5 kg at birth and this generally results in more caesarean sections because passage through the birth canal in a normal labour increases the risk of shoulder dystocia, bone fractures and subconjunctival haemorrhage 73 . GDM increases the risk of congenital heart defects 74 . and infants born to women with GDM are at greater risk of childhood obesity 75 …”

“…73 GDM increases the risk of congenital heart defects. 74 and infants born to women with GDM are at greater risk of childhood obesity. 75 The association between obesity and GDM is well documented.…”

Incidence of nonsyndromic congenital heart defects in the Republic of Srpska in the period 2015-2016

“…It is well known that advanced maternal age increases the incidence of chromosomal disorders and therefore the incidence of CHD related to these disorders. Since we studied only cases without chromosomal anomalies, a possible explanation for this finding could be other risk factors associated with advanced maternal age, such as poor glycemic control, higher body mass index and the advanced age of their partners [18][19][20][21] . Also, the higher incidence of premature birth in older women increases the incidence of ventricular septal defect at birth by detecting those defects that would close spontaneously till the term 22 .…”

Prenatal diagnosis of hypoplastic aortic arch without intracardiac malformations: The nevada experience

“…We previously demonstrated an association between advanced maternal age or other maternal comorbidities and some forms of critical congenital heart disease, isomeric situs, and vascular rings 17–20 . Others have also shown associations with advanced maternal or maternal comorbidities and congenital heart disease 21–24 . Embedding our fetal cardiologists in all the state's maternal‐fetal‐medicine clinics provides a population of high‐risk pregnancies comprised of both those with maternal comorbidities and abnormal routine obstetric ultrasounds or both.…”