This article is more than 5 years old. Information may no longer be current.
Degree of maternal obesity during pregnancy tied to heart defect risk in children
The severity of maternal obesity may be associated with elevated atrial septal defects and persistent ductus arteriosus in offspring, according to findings published in the Journal of the American College of Cardiology.
Martina Persson, MD, PhD, of the department of medicine, clinical epidemiology unit, and department of clinical science and education at Karolinska Institutet in Solna, Sweden, and colleagues analyzed associations between the severity of maternal obesity and the rates of complex and specific heart defects.
“Given the increasing number of women with obesity in pregnancy and the potential severity of congenital heart defects, it is important to clarify the associations between BMI and risks of specific heart defects,” the researchers wrote.
Persson and colleagues examined data from a population-based cohort study in Sweden that included 2,050,491 live singleton infants born between 1992 and 2012.
The researchers examined data in six maternal BMI classes: underweight (< 18.5 kg/m2), normal weight (18.5 to < 25 kg/m2), overweight (25 to < 30 kg/m2), obesity class I (30 to < 35 kg/m2), class II (35 to < 40 kg/m2) and class III ( 40 kg/m2). The outcomes of interest were complex heart defects and subgroups of specific heart defects diagnosed up to age 5 years.
According to the researchers, 1.4% of children had at least one heart defect.
In mothers classified as overweight, offspring had a lower prevalence rate ratio of atrial septal defects (prevalence rate ratio [PRR] = 1.08; 95% CI, 1.02-1.14) compared with offspring of mothers with obesity class III (PRR = 1.65; 95% CI, 1.34-2.03, P for trend < .0001), the researchers wrote.
Rates for persistent ductus arteriosus in offspring increased among mothers in obesity class III (PRR = 2.32; 95% CI, 1.73-3.12) compared with infants of overweight mothers (PRR = 1.16; 95% CI, 1.06-1.27; P for trend < .0001).
“Maternal overweight and obesity are prevalent and potentially modifiable risk factors for congenital heart defects in offspring. The most vulnerable period of fetal organ development occurs in the first 8 weeks of pregnancy,” Persson and colleagues wrote. “Thus, primary prevention aiming at reducing the prevalence of overweight and obesity in women in reproductive age is essential for reducing obesity-related risks of congenital heart defects.”
In a related editorial, Adolfo Correa, MD, PhD, from the department of medicine at the University of Mississippi Medical Center in Jackson, Mississippi, wrote: “In addition to encouraging more public health messages on the importance of maintaining a healthy prepregnancy BMI, there is an urgent need for innovative multisectorial and transdisciplinary approaches and resources to reduce or prevent obesity before, during and after pregnancy through concerted efforts of individuals, communities and policy initiatives that facilitate ready and equitable access to information and healthy choices.” – by Earl Holland Jr.
Disclosures: The authors and Correa report no relevant financial disclosures.