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Risk of neural tube defects according to maternal body mass index: a systematic review and meta-analysis

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE (2022)

Journal

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE

Volume 35, Issue 25, Pages 7296-7305

Publisher

TAYLOR & FRANCIS LTD

DOI: 10.1080/14767058.2021.1946789

Keywords

Maternal obesity; BMI; neural tube defect; fetal defect; underweight

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Abstract

Obese pregnant women are at significantly higher risk of NTDs, such as spina bifida, compared with normal weight women. No significant difference was found in overweight and underweight pregnant women when compared with normal weight women.

Introduction The aim of our systematic review and meta-analysis was to evaluate the risk of neural tube defects (NTDs) according to the pre-pregnancy body mass index. Materials and methods Electronic databases were searched (MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID, and Cochrane Library). Selection criteria included prospective and retrospective cohort studies reporting the prevalence of fetal NTDs in obese, overweight, and underweight pregnant women. Odds ratios (ORs) comparing risk among these subsets of pregnancies with normal weight mothers were determined with 95% confidence intervals (CI). The evaluated outcome was the association between maternal underweight, overweight, and obesity and the risk of NTDs. Results We included ten studies published between 2000 and 2017, including underweight, overweight, and obese pregnant women with fetal NTD (cases) and pregnant women with recommended BMI with fetal NTD (controls). Compared with normal BMI women, obese mothers were at significantly higher risk of fetal NTDs (0.53 vs. 0.33%; OR 1.62 95% CI 1.32-1.99, p < .0001), while no difference for the risk of NTDs was found when comparing overweight (0.34 vs. 0.32%; OR 1.09 95% CI 0.92-1.3, p = .3) and underweight (0.65 vs. 0.24%; OR 1.34 95% CI 0.73-2.47, p = .34) with normal weight pregnant women. Discussion Obese pregnant women are at significantly higher risk NTDs, while no significant difference has been found in overweight and underweight pregnant women. Key message Obese pregnant women are at significantly higher risk of NTDs, such as spina bifida compared with normal weight women. No difference was found when comparing overweight and underweight with normal weight women.

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Association of maternal pre-pregnancy low or increased body mass index with adverse pregnancy outcomes

Jie Tang, Xinhong Zhu, Yanbing Chen, Dongming Huang, Henning Tiemeier, Ruoling Chen, Wei Bao, Qingguo Zhao

Summary: This study found that in the Chinese population, maternal pre-pregnancy BMI was significantly associated with the risk of adverse pregnancy outcomes, and this risk varied according to maternal age. Further research is needed to explore whether and how counseling and interventions for women with either low or high BMI before pregnancy can reduce the risk of adverse pregnancy outcomes.

SCIENTIFIC REPORTS (2021)