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CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(05): 280-290
DOI: 10.1055/s-0039-1683971
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Prevalence and Association of Congenital Anomalies According to the Maternal Body Mass Index: Cross-Sectional Study

Prevalência e associação de anomalias congênitas de acordo com índice de massa corporal materno: Estudo transversal
Carolina Leão de Moraes 
1   Faculty of Medicine, Department of Obstetrics and Gynecology, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, GO, Brazil
,
Carolina Rodrigues Mendonça
1   Faculty of Medicine, Department of Obstetrics and Gynecology, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, GO, Brazil
,
Natália Cruz e Melo
2   Paulista Medical School, Universidade Federal de São Paulo, São Paulo, SP, Brazil
,
Waldemar Naves do Amaral
1   Faculty of Medicine, Department of Obstetrics and Gynecology, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, GO, Brazil
› Author Affiliations
Further Information

Publication History

17 September 2018

08 February 2019

Publication Date:
08 April 2019 (online)

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Abstract

Objective To evaluate and compare the prevalence of structural congenital anomalies (CAs) according to maternal body mass index (BMI).

Methods The present cross-sectional study involved pregnant women with fetuses diagnosed with structural CAs through morphological ultrasonography between November 2014 and January 2016. The nutritional status of the pregnant women was classified according to the gross value of the body mass index. The pregnant women were categorized into four groups: low weight, adequate weight, overweight, and obesity. Statistical analysis was performed using Stata/SE version 12.0 (Stata Corporation, College Station, TX), with values of p ≤ 0.05 considered statistically significant.

Results A total of 223 pregnant women had fetuses diagnosed with CAs. The prevalence of structural CAs in pregnant women with low weight was of 20.18%, of 43.50% in pregnant women with adequate weight, of 22.87% in pregnant women with overweight, and of 13.45% in pregnant women with obesity. The prevalence of central nervous system (CNS) anomalies and of genitourinary system anomalies was high for the four groups of pregnant women. A positive association was observed between multiple anomalies in pregnant women with adequate weight (prevalence ratio [PR] = 1.65; p ≤ 0.004) and between anomalies of the lymphatic system in obese pregnant women (PR = 4.04, p ≤ 0.000).

Conclusion The prevalence of CNS and genitourinary system anomalies was high in all of the BMI categories. Obese pregnancies were associated with lymphatic system anomalies. Therefore, screening and identification of the risk factors for CAs are important, regardless of the maternal BMI. Our findings reinforce the importance of discussing with pregnant women maternal nutrition and its effect on fetal development and on neonatal outcome.

Resumo

Objetivo Avaliar e comparar a prevalência de anomalias congênitas (ACs) estruturais de acordo com o índice de massa corporal (IMC) materno.

Métodos Estudo transversal envolvendo gestantes com fetos diagnosticados com ACs estruturais por ultrassonografia morfológica entre novembro de 2014 e janeiro de 2016. O estado nutricional das gestantes foi classificado de acordo com o valor bruto do índice de massa corporal. As gestantes foram categorizadas em quatro grupos: baixo peso, peso adequado, sobrepeso e obesidade. A análise estatística foi realizada no programa Stata/SE versão 12.0 (Stata Corporation, College Station, TX), com valores de p ≤0,05 considerados estatisticamente significantes.

Resultados Um total de 223 gestantes tiveram fetos diagnosticados com ACs. A prevalência de AC estrutural em gestantes com baixo peso foi de 20,18%, em gestantes com peso adequado foi de 43,50%, em gestantes com sobrepeso foi de 22,87%, e em gestantes com obesidade foi de 13,45%. A prevalência de anomalias do sistema nervoso central (SNC) e do sistema geniturinário foi alta para os quatro grupos. Observou-se associação positiva entre múltiplas anomalias em gestantes com peso adequado (razão de prevalência [RP] = 1,65; p ≤ 0,004) e entre anomalias do sistema linfático em gestantes obesas (RP = 4,04, p ≤ 0,000).

Conclusão A prevalência das anomalias do SNC e do sistema geniturinário foi alta em todas as categorias de IMC. Gestantes obesas foram associadas a anomalias do sistema linfático. Portanto, o rastreamento e a identificação dos fatores de risco para as AC são importantes, independentemente do IMC materno. Nossos achados reforçam a importância de discutir com gestantes sobre a nutrição materna e seu efeito no desenvolvimento fetal e no desfecho neonatal.

Keywords

congenital anomalies - pregnancy - obesity - body weight - fetal ultrasonography

Palavras-chave

anomalias congênitas - gravidez - obesidade - peso corporal - ultrassonografia fetal

Contributors

All of the authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.


 

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