American Journal of Obstetrics & Gynecology
Volume 202, Issue 1 , Pages 51.e1-51.e10 , January 2010

Association between prepregnancy body mass index and congenital heart defects

Presented at the 13th Annual Maternal and Child Health Epidemiology Conference, Atlanta, GA, Dec. 10-12, 2007.

  • Suzanne M. Gilboa, PhD

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
  • ,
  • Adolfo Correa, MD, PhD

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
  • ,
  • Lorenzo D. Botto, MD

      Affiliations

    • Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
  • ,
  • Sonja A. Rasmussen, MD, MS

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
  • ,
  • D. Kim Waller, PhD

      Affiliations

    • School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX
  • ,
  • Charlotte A. Hobbs, MD, PhD

      Affiliations

    • Department of Pediatrics, Birth Defects Research Section, University of Arkansas for Medical Sciences and Arkansas Children's Hospital Research Institute, Little Rock, AR
  • ,
  • Mario A. Cleves, PhD

      Affiliations

    • Department of Pediatrics, Birth Defects Research Section, University of Arkansas for Medical Sciences and Arkansas Children's Hospital Research Institute, Little Rock, AR
  • ,
  • Tiffany J. Riehle-Colarusso, MD, MSE

      Affiliations

    • National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
  • ,
  • National Birth Defects Prevention Study

Received 21 January 2009 ,Revised 9 July 2009 ,Accepted 6 August 2009.

References 

  1. Reller MD, Strickland MJ, Riehle-Colarusso T, Mahle WT, Correa A. Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005. J Pediatr. 2008;807–813
  2. Yang Q, Chen H, Correa A, Devine O, Mathews TJ, Honein MA. Racial differences in infant mortality attributable to birth defects in the United States, 1989-2002. Birth Defects Res A Clin Mol Teratol. 2006;76:706–713
  3. Boneva RS, Botto LD, Moore CA, Yang Q, Correa A, Erickson JD. Mortality associated with congenital heart defects in the United States: trends and racial disparities, 1979-1997. Circulation. 2001;103:2376–2381
  4. Centers for Disease Control and Prevention (CDC). Economic costs of birth defects and cerebral palsy—United States, 1992. MMWR Morb Mortal Wkly Rep. 1995;44:694–699
  5. Correa A, Gilboa SM, Besser LM, et al. Diabetes mellitus and birth defects. Am J Obstet Gynecol. 2008;199:237.e1–237.e9
  6. Becerra JE, Khoury MJ, Cordero JF, Erickson JD. Diabetes mellitus during pregnancy and the risks of specific birth defects: a population-based case-control study. Pediatrics. 1990;85:1–9
  7. Cedergren MI, Kallen BA. Maternal obesity and infant heart defects. Obes Res. 2003;11:1065–1071
  8. Mikhail LN, Walker CK, Mittendorf R. Association between maternal obesity and fetal cardiac malformations in African Americans. J Natl Med Assoc. 2002;94:695–700
  9. Shaw GM, Carmichael SL. Prepregnant obesity and risks of selected birth defects in offspring. Epidemiology. 2008;19:616–620
  10. Shaw GM, Todoroff K, Schaffer DM, Selvin S. Maternal height and prepregnancy body mass index as risk factors for selected congenital anomalies. Paediatr Perinat Epidemiol. 2000;14:234–239
  11. Watkins ML, Botto LD. Maternal prepregnancy weight and congenital heart defects in offspring. Epidemiology. 2001;12:439–446
  12. Watkins ML, Rasmussen SA, Honein MA, Botto LD, Moore CA. Maternal obesity and risk for birth defects. Pediatrics. 2003;111:1152–1158
  13. Waller DK, Shaw GM, Rasmussen SA, et al. Prepregnancy obesity as a risk factor for structural birth defects. Arch Pediatr Adolesc Med. 2007;161:745–750
  14. Waller DK, Mills JL, Simpson JL, et al. Are obese women at higher risk for producing malformed offspring?. Am J Obstet Gynecol. 1994;170:541–548
  15. Kim SY, Dietz PM, England L, Morrow B, Callaghan WM. Trends in pre-pregnancy obesity in nine states, 1993-2003. Obesity (Silver Spring). 2007;15:986–993
  16. Callaway LK, Prins JB, Chang AM, McIntyre HD. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust. 2006;184:56–59
  17. Cameron AJ, Welborn TA, Zimmet PZ, et al. Overweight and obesity in Australia: the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust. 2003;178:427–432
  18. Ehrenberg HM, Durnwald CP, Catalano P, Mercer BM. The influence of obesity and diabetes on the risk of cesarean delivery. Am J Obstet Gynecol. 2004;191:969–974
  19. Ehrenberg HM, Mercer BM, Catalano PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol. 2004;191:964–968
  20. Jensen DM, Damm P, Sorensen B, et al. Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant Danish women. Am J Obstet Gynecol. 2003;189:239–244
  21. Jolly MC, Sebire NJ, Harris JP, Regan L, Robinson S. Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies. Eur J Obstet Gynecol Reprod Biol. 2003;111:9–14
  22. Anderson JL, Waller DK, Canfield MA, Shaw GM, Watkins ML, Werler MM. Maternal obesity, gestational diabetes, and central nervous system birth defects. Epidemiology. 2005;16:87–92
  23. Moore LL, Singer MR, Bradlee ML, Rothman KJ, Milunsky A. A prospective study of the risk of congenital defects associated with maternal obesity and diabetes mellitus. Epidemiology. 2000;11:689–694
  24. Shaw GM, Nelson V, Moore CA. Prepregnancy body mass index and risk of multiple congenital anomalies. Am J Med Genet. 2002;107:253–255
  25. Werler MM, Louik C, Shapiro S, Mitchell AA. Prepregnant weight in relation to risk of neural tube defects. JAMA. 1996;275:1089–1092
  26. Rasmussen SA, Chu SY, Kim SY, Schmid CH, Lau J. Maternal obesity and risk of neural tube defects: a metaanalysis. Am J Obstet Gynecol. 2008;198:611–619
  27. Yoon PW, Rasmussen SA, Lynberg MC, et al. The National Birth Defects Prevention Study. Public Health Rep. 2001;116:32–40
  28. Botto LD, Lin AE, Riehle-Colarusso T, Malik S, Correa A National Birth Defects Prevention Study. Seeking causes: classifying and evaluating congenital heart defects in etiologic studies. Birth Defects Res A Clin Mol Teratol. 2007;79:714–727
  29. Rasmussen SA, Olney RS, Holmes LB, et al. Guidelines for case classification for the National Birth Defects Prevention Study. Birth Defects Research (Part A). 2003;67:193–201
  30. Marshall SW. Power for tests of interaction: effect of raising the type I error rate. Epidemiol Perspect Innov. 2007;4:4
  31. Andersson T, Alfredsson L, Kallberg H, Zdravkovic S, Ahlbom A. Calculating measures of biological interaction. Eur J Epidemiol. 2005;20:575–579
  32. Brunner Huber L. Validity of self-reported height and weight in women of reproductive age. Matern Child Health J. 2006;11:137–144
  33. Rowland ML. Self-reported weight and height. Am J Clin Nutr. 1990;52:1125–1133
  34. Hendler I, Blackwell SC, Bujold E, et al. The impact of maternal obesity on midtrimester sonographic visualization of fetal cardiac and craniospinal structures. Int J Obes Relat Metab Disord. 2004;28:1607–1611
  35. Cragan JD, Gilboa SM. Including prenatal diagnoses in birth defects monitoring: experience of the Metropolitan Atlanta Congenital Defects Program. Birth Defects Res A Clin Mol Teratol. 2009;85:20–29
  36. Rosenberg TJ, Garbers S, Chavkin W, Chiasson MA. Prepregnancy weight and adverse perinatal outcomes in an ethnically diverse population. Obstet Gynecol. 2003;102:1022–1027
  37. Di Cianni G, Volpe L, Lencioni C, et al. Prevalence and risk factors for gestational diabetes assessed by universal screening. Diabetes Res Clin Pract. 2003;62:131–137
  38. Chu SY, Callaghan WM, Kim SY, et al. Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care. 2007;30:2070–2076
  39. Garcia-Patterson A, Erdozain L, Ginovart G, et al. In human gestational diabetes mellitus congenital malformations are related to pre-pregnancy body mass index and to severity of diabetes. Diabetologia. 2004;47:509–514
  40. Martinez-Frias ML, Frias JP, Bermejo E, Rodriguez-Pinilla E, Prieto L, Frias JL. Pre-gestational maternal body mass index predicts an increased risk of congenital malformations in infants of mothers with gestational diabetes. Diabet Med. 2005;22:775–781
  41. Martinez-Frias ML, Bermejo E, Rodriguez-Pinilla E, Prieto L, Frias JL. Epidemiological analysis of outcomes of pregnancy in gestational diabetic mothers. Am J Med Genet. 1998;78:140–145
  42. Schaefer-Graf UM, Buchanan TA, Xiang A, Songster G, Montoro M, Kjos SL. Patterns of congenital anomalies and relationship to initial maternal fasting glucose levels in pregnancies complicated by type 2 and gestational diabetes. Am J Obstet Gynecol. 2000;182:313–320
  43. Eriksson UJ, Cederberg J, Wentzel P. Congenital malformations in offspring of diabetic mothers—animal and human studies. Rev Endocr Metab Disord. 2003;4:79–93
  44. Kahn SE, Hull RL, Utzschneider KM. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444:840–846
  45. Karelis AD, St Pierre DH, Conus F, Rabasa-Lhoret R, Poehlman ET. Metabolic and body composition factors in subgroups of obesity: what do we know?. J Clin Endocrinol Metab. 2004;89:2569–2575
  46. Zhang C, Solomon CG, Manson JE, Hu FB. A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Arch Intern Med. 2006;166:543–548
  47. Carmichael SL, Shaw GM, Schaffer DM, Laurent C, Selvin S. Dieting behaviors and risk of neural tube defects. Am J Epidemiol. 2003;158:1127–1131
  48. Laraia BA, Bodnar LM, Siega-Riz AM. Pregravid body mass index is negatively associated with diet quality during pregnancy. Public Health Nutr. 2007;10:920–926
  49. Carmichael SL, Shaw GM, Neri E, Schaffer DM, Selvin S. Physical activity and risk of neural tube defects. Matern Child Health J. 2002;6:151–157
  50. Case AP, Ramadhani TA, Canfield MA, Beverly L, Wood R. Folic acid supplementation among diabetic, overweight, or obese women of childbearing age. J Obstet Gynecol Neonatal Nurs. 2007;36:335–341
  51. Kimmons JE, Blanck HM, Tohill BC, Zhang J, Khan LK. Associations between body mass index and the prevalence of low micronutrient levels among US adults. MedGenMed. 2006;8:59

 This work was supported in part through cooperative agreements under Program Announcement #02081 from the Centers for Disease Control and Prevention to the centers participating in the National Birth Defects Prevention Study.

 Reprints not available from the authors.

 The views expressed herein are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

 Cite this article as: Gilboa SM, Correa A, Botto LD, et al. Association between prepregnancy body mass index and congenital heart defects. Am J Obstet Gynecol 2010;202:51.e1-10.

PII: S0002-9378(09)00903-X

doi: 10.1016/j.ajog.2009.08.005

American Journal of Obstetrics & Gynecology
Volume 202, Issue 1 , Pages 51.e1-51.e10 , January 2010