Maternal Overweight and Obesity and the Risk of Congenital Anomalies

Stothard, K J; Tennant, Pwg; Bell, Ruth; Rankin, Judith

doi:10.1001/jama.2009.113

Cited by 1,075 publications

(833 citation statements)

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“…12,16,31 Congenital abnormalities are also described more commonly in infants of obese mothers, including neural tube defects, orofacial abnormalities, cardiac defects, limb reduction defects and intestinal tract anomalies such as anorectal atresia and omphalocele. 8,13,32 The most commonly occurring congenital anomalies are neural tube defects (aOR 1.87 obese; 1.2 overweight) followed by cardiovascular anomaly (aOR 1.30 obese; 1.17 overweight). Within these groups spina bifida (aOR 2.2 obese) and cardiac septal anomalies (aOR 1.20) were the most frequent.…”

Section: Adverse Fetal and Neonatal Outcomesmentioning

confidence: 99%

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The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

Dennedy

Dunne

2010

Best Practice & Research Clinical Endocrinology & Metab

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Section: Adverse Fetal and Neonatal Outcomesmentioning

confidence: 99%

“…Within these groups spina bifida (aOR 2.2 obese) and cardiac septal anomalies (aOR 1.20) were the most frequent. 32 Not surprisingly there is also an increased risk of stillbirth and perinatal death. 33 M.C.…”

Section: Adverse Fetal and Neonatal Outcomesmentioning

confidence: 99%

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

Dennedy

Dunne

2010

Best Practice & Research Clinical Endocrinology & Metab

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“…There are significantly increased associations with adverse outcomes for women and babies including congenital anomalies, perinatal mortality, macrosomia, gestational diabetes, maternal infections and preterm birth (Heslehurst et al, 2008;Stothard et al, 2009;Tennant et al, 2011;Lutsiv et al, 2015). In the UK, there are clinical guidelines to detect and manage co-morbidities associated with obesity (e.g.…”

Section: Introductionmentioning

confidence: 99%

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

et al. 2017

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Objective: To understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity.Design: A qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes.Setting: One NHS Trust maternity and dietetic services, North East England, UK Participants: Fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0-2, and BMI range 30-51kg/m 2 .Findings: Four themes were identified within this concept. 1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified.2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. 3) 2 Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. 4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring.Key conclusions: Women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base.Implications for practice: It is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate personcentred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy.Keywords obesity, body mass index, dietetic, qualitative, experience, pregnancy IntroductionMaternal obesity (body mass index (BMI) ≥30kg/m 2 ) is increasing in prevalence internationally (Brynhildsen et al., 2006;Ray et al., 2007;Heslehurst et al., 2010;Fisher et al., 2013) and is associated with complex inequalities, including deprivation and ethnic minority groups (Heslehurst et al., 2010(Heslehurst et al., , 2012. There are significantly increased associations with adverse outcomes for women and babies including congenital anomalies, perinatal mortality, macrosomia, gestational diabetes, maternal infections and preterm birth (Heslehurst et al., 2008;Stothard et al., 2009;Tenn...

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“…Young maternal age is the most consistently reported risk factor (Baerg et al, 2003;Feldkamp et al, 2007;Hougland et al, 2005;Saada et al, 2005). Other maternal factors that have been suspected to increase gastroschisis risk include maternal smoking, maternal use of vasoactive substances, low socioeconomic status, low pregnancy body mass index, and Hispanic ethnicity (Haddow et al, 1993;Torfs et al, 1994;Lam et al, 1999;Werler et al, 2002;Salihu et al, 2003;Saada et al, 2005;Canfield et al, 2006;Feldkamp et al, 2007;Stothard et al, 2009). More recently, maternal birthplace (nativity) has been reported to affect the risk of congenital malformations, including gastroschisis; foreign-born women have a lower risk of delivering an infant with gastroschisis than U.S.-born women (Zhu et al, 2006;Vu et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Maternal nativity as a risk factor for gastroschisis: A population‐based study

Salemi

Pierre

Tanner

et al. 2009

Birth Defects Research

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BACKGROUND:The prevalence of gastroschisis is increasing in many parts of the world, although the etiology is largely unexplained. Young maternal age has been the only consistently identified, strong risk factor. The objective of this study was to examine the role of maternal nativity in relation to other suspected risk factors for gastroschisis in Florida. METHODS: We conducted a retrospective cohort study of singleton infants born in Florida from 1998-2003. Gastroschisis cases were identified from the Florida Birth Defects Registry. Demographic and perinatal data were obtained from birth records. Multivariable Poisson regression was used to estimate adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs) for each factor of interest. RESULTS: The 6-year birth prevalence of gastroschisis was 3.26 per 10,000 live births, and the annual rate increased 41% during the study period. In addition to maternal age and marital status, maternal race/ethnicity and nativity were significantly associated with the risk of delivering an infant with gastroschisis. Compared with non-Hispanic white women, non-Hispanic black women had the lowest risk of delivering an infant with gastroschisis (PR, 0.19; 95% CI, 0.13-0.26), followed by Hispanic women (PR, 0.60; 95% CI, 0.43-0.83). Women born outside the United States were significantly less likely than U.S.-born women to deliver an infant with gastroschisis (PR, 0.59; 95% CI, 0.41-0.86). CONCLUSIONS: Although young maternal age remains a strong significant risk factor for gastroschisis in Florida, other factors such as maternal race/ ethnicity and nativity could be important in explaining the increasing prevalence of gastroschisis. Birth

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Maternal Overweight and Obesity and the Risk of Congenital Anomalies

Cited by 1,075 publications

References 67 publications

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

Maternal nativity as a risk factor for gastroschisis: A population‐based study

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