Maternal Obesity and Morbid Obesity: the Risk for Birth Defects in the Offspring
Maternal Obesity and Morbid Obesity: the Risk for Birth Defects in the Offspring
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DOI：
10.1002/bdra.20620
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发表时间：
2010-01-01
影响因子：
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通讯作者：
Kallen, Bengt
中科院分区：
文献类型：
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作者：
Blomberg, Marie I.;Kallen, Bengt
背景：本研究的目的是评估来自瑞典医疗卫生登记处的大量数据集，产妇肥胖和产妇病态肥胖是否与各种结构性出生缺陷的风险增加相关。方法：研究人群包括1995年1月1日至2007年12月31日在瑞典出生的1,049,582名婴儿，其中已知母亲的体重和身高数据。根据世界卫生组织的分类，女性的身体质量指数（BMI）分为六类。有先天性出生缺陷的婴儿是从三个来源确定的：瑞典医疗出生登记处、出生缺陷登记册和国家患者登记册。产妇年龄、胎次、吸烟和出生年份被认为是潜在的混杂因素，并作为协变量纳入调整优势比分析。结果：10%的研究人群肥胖。病态肥胖（BMI >= 40）发生率为0.7%。先天性畸形患病率为4.7%，较重度畸形患病率为3.2%。孕妇孕前病态肥胖与神经管缺陷OR 4.08 （95% CI 1.87-7.75）、心脏缺陷OR 1.49 （95% CI 1.24-1.80）、口面裂OR 1.90 （95% CI 1.27-2.86）相关。产妇肥胖（BMI >= 30）显著增加了脑积水、肛门闭锁、尿道下裂、囊性肾、马蹄内翻、脐膨出和膈疝的风险。结论：病态肥胖孕妇生下先天性婴儿缺陷的风险很小，但鉴于肥胖的持续流行，对社会来说，这种关联是重要的。出生缺陷研究（A辑）88:35-40,2010。(C) 2009 Wiley-Liss, Inc。
BACKGROUND: The objective of this study was to assess, in a large data set from Swedish Medical Health Registries, whether maternal obesity and maternal morbid obesity were associated with an increased risk for various structural birth defects. METHODS: The study population consisted of 1,049,582 infants born in Sweden from January 1, 1995, through December 31, 2007, with known maternal weight and height data. Women were grouped in six categories of body mass index (BMI) according to World Health Organization classification. Infants with congenital birth defects were identified from three sources: the Swedish Medical Birth Registry, the Register of Birth Defects, and the National Patient Register. Maternal age, parity, smoking, and year of birth were thought to be potential confounders and were included as covariates in the adjusted odds ratio analyses. RESULTS: Ten percent of the study population was obese. Morbid obesity (BMI >= 40) occurred in 0.7%. The prevalence of congenital malformations was 4.7%, and the prevalence of relatively severe malformations was 3.2%. Maternal prepregnancy morbid obesity was associated with neural tube defects OR 4.08 (95% CI 1.87-7.75), cardiac defects OR 1.49 (95% CI 1.24-1.80), and orofacial clefts OR 1.90 (95% CI 1.27-2.86). Maternal obesity (BMI >= 30) significantly increased the risk of hydrocephaly, anal atresia, hypospadias, cystic kidney, pes equinovarus, omphalocele, and diaphragmatic hernia. CONCLUSION: The risk for a morbidly obese pregnant woman to have an infant with a congenital birth defect is small, but for society the association is important in the light of the ongoing obesity epidemic. Birth Defects Research (Part A) 88:35-40, 2010. (C) 2009 Wiley-Liss, Inc.