Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Current Obstetrics and Gynecology Reports
Erschienen in: Current Obstetrics and Gynecology Reports 2/2023

21.03.2023 | REVIEW

Congenital Anomalies in Women with Obesity

verfasst von: Katherine Pressman, Sarah Običan

Erschienen in: Current Obstetrics and Gynecology Reports | Ausgabe 2/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

In addition to a general overview of congenital anomalies in pregnant people with obesity as well as new data on the topic, this review aims to discuss the challenges in antenatal diagnosis of anomalies via sonogram.

Recent Findings

Obesity is associated with a dose-dependent increase in risk of certain congenital anomalies including cardiac malformations. The risk reduction of neural tube defects with folic acid supplementation is not as significant in offspring of patients with obesity compared to their normal weight counterparts. The addition of an early anatomy scan at 13 to15 weeks in addition to the traditionally timed anatomy scan may improve completion of the scan and increase identification of anomalies.

Summary

The overall risk of congenital anomalies is 3–5%. This risk increases with maternal obesity. Pregnant people with obesity are at higher risk of multiple types of anomalies in various organ systems, including cardiovascular, renal, and neurologic systems. Several of these are associated with a dose-dependent risk such that the risk is greater with increasing BMI. Along with the increased risk of anomalies, maternal obesity is also associated with lower quality sonogram images and poorer rates of completion of anatomy scans at initial attempt.
Literatur
1.
2.
Obesity in pregnancy. ACOG Practice Bulletin, Number 230. Obstet Gynecol. 2021;137(6):e128–44.CrossRef
3.
4.
Persson M, Cnattingius S, Villamor E, Söderling J, Pasternak B, Stephansson O, et al. Risk of major congenital malformations in relation to maternal overweight and obesity severity: cohort study of 1.2 million singletons. Bmj. 2017;357:j2563.
5.
Stothard KJ, Tennant PW, Bell R, Rankin J. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA. 2009;301(6):636–50.PubMedCrossRef
6.
van de Putte R, de Walle HEK, van Hooijdonk KJM, de Blaauw I, Marcelis CLM, van Heijst A, et al. Maternal risk associated with the VACTERL association: a case-control study. Birth Defects Res. 2020;112(18):1495–504.PubMedPubMedCentralCrossRef
7.
Reller MD, Strickland MJ, Riehle-Colarusso T, Mahle WT, Correa A. Prevalence of congenital heart defects in metropolitan Atlanta, 1998–2005. J Pediatr. 2008;153(6):807–13.PubMedPubMedCentralCrossRef
8.
Egbe A, Uppu S, Stroustrup A, Lee S, Ho D, Srivastava S. Incidences and sociodemographics of specific congenital heart diseases in the United States of America: an evaluation of hospital discharge diagnoses. Pediatr Cardiol. 2014;35(6):975–82.PubMedCrossRef
9.
Watkins ML, Rasmussen SA, Honein MA, Botto LD, Moore CA. Maternal obesity and risk for birth defects. Pediatrics. 2003;111(5 Pt 2):1152–8.PubMedCrossRef
10.
Waller DK, Shaw GM, Rasmussen SA, Hobbs CA, Canfield MA, Siega-Riz AM, et al. Prepregnancy obesity as a risk factor for structural birth defects. Arch Pediatr Adolesc Med. 2007;161(8):745–50.PubMedCrossRef
11.
Brite J, Laughon SK, Troendle J, Mills J. Maternal overweight and obesity and risk of congenital heart defects in offspring. Int J Obes (Lond). 2014;38(6):878–82.PubMedCrossRef
12.
Persson M, Razaz N, Edstedt Bonamy AK, Villamor E, Cnattingius S. Maternal overweight and obesity and risk of congenital heart defects. J Am Coll Cardiol. 2019;73(1):44–53.PubMedCrossRef
13.
Engineer A, Saiyin T, Greco ER, Feng Q. Say NO to ROS: their roles in embryonic heart development and pathogenesis of congenital heart defects in maternal diabetes. Antioxidants (Basel). 2019;8(10).
14.
Jarvie E, Hauguel-de-Mouzon S, Nelson SM, Sattar N, Catalano PM, Freeman DJ. Lipotoxicity in obese pregnancy and its potential role in adverse pregnancy outcome and obesity in the offspring. Clin Sci (Lond). 2010;119(3):123–9.PubMedCrossRef
15.
He X, Hong X, Zeng F, Kang F, Li L, Sun Q. Zinc antagonizes homocysteine-induced fetal heart defects in rats. Cardiovasc Toxicol. 2009;9(3):151–9.PubMedCrossRef
16.
Kumar SD, Vijaya M, Samy RP, Dheen ST, Ren M, Watt F, et al. Zinc supplementation prevents cardiomyocyte apoptosis and congenital heart defects in embryos of diabetic mice. Free Radic Biol Med. 2012;53(8):1595–606.PubMedCrossRef
17.
Yang J, Kang Y, Chang Q, Zhang B, Liu X, Zeng L, et al. Maternal zinc, copper, and selenium intakes during pregnancy and congenital heart defects. Nutrients. 2022;14(5).
18.
Maffoni S, De Giuseppe R, Stanford FC, Cena H. Folate status in women of childbearing age with obesity: a review. Nutr Res Rev. 2017;30(2):265–71.PubMedPubMedCentralCrossRef
19.
Bird JK, Murphy RA, Ciappio ED, McBurney MI. Risk of deficiency in multiple concurrent micronutrients in children and adults in the United States. Nutrients. 2017;9(7).
20.
21.
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(6):611–9.PubMedCrossRef
22.
Benjamin RH, Ethen MK, Canfield MA, Hua F, Mitchell LE. Association of interpregnancy change in body mass index and spina bifida. Birth Defects Res. 2019;111(18):1389–98.PubMedCrossRef
23.
Arbuzova S, Nikolenko M, Cuckle H. Maternal weight as an additional first trimester spina bifida screening marker. J Matern Fetal Neonatal Med. 2022;35(17):3353–8.PubMedCrossRef
24.
Pace ND, Siega-Riz AM, Olshan AF, Chescheir NC, Cole SR, Desrosiers TA, et al. Survival of infants with spina bifida and the role of maternal prepregnancy body mass index. Birth Defects Res. 2019;111(16):1205–16.PubMedPubMedCentralCrossRef
25.
Shaw GM, Velie EM, Schaffer D. Risk of neural tube defect-affected pregnancies among obese women. JAMA. 1996;275(14):1093–6.PubMedCrossRef
26.
Zhang L, Zhang Y, Li Z, Ren A, Liu J, Ye R. Maternal periconceptional body mass index and risk for neural tube defects: results from a large cohort study in China. J Matern Fetal Neonatal Med. 2021;34(2):274–80.PubMedCrossRef
27.
Lupo PJ, Canfield MA, Chapa C, Lu W, Agopian AJ, Mitchell LE, et al. Diabetes and obesity-related genes and the risk of neural tube defects in the national birth defects prevention study. Am J Epidemiol. 2012;176(12):1101–9.PubMedPubMedCentralCrossRef
28.
Wang M, Wang ZP, Gao LJ, Gong R, Sun XH, Zhao ZT. Maternal body mass index and the association between folic acid supplements and neural tube defects. Acta Paediatr. 2013;102(9):908–13.PubMedCrossRef
29.
Parker SE, Yazdy MM, Tinker SC, Mitchell AA, Werler MM. The impact of folic acid intake on the association among diabetes mellitus, obesity, and spina bifida. Am J Obstet Gynecol. 2013;209(3):239.e1-8.PubMedCrossRef
30.
da Silva VR, Hausman DB, Kauwell GP, Sokolow A, Tackett RL, Rathbun SL, et al. Obesity affects short-term folate pharmacokinetics in women of childbearing age. Int J Obes (Lond). 2013;37(12):1608–10.PubMedCrossRef
31.
Tinker SC, Hamner HC, Berry RJ, Bailey LB, Pfeiffer CM. Does obesity modify the association of supplemental folic acid with folate status among nonpregnant women of childbearing age in the United States? Birth Defects Res A Clin Mol Teratol. 2012;94(10):749–55.PubMedCrossRef
32.
Giouleka S, Tsakiridis I, Koutsouki G, Kostakis N, Mamopoulos A, Kalogiannidis I, et al. Obesity in pregnancy: a comprehensive review of influential guidelines. Obstet Gynecol Surv. 2023;78(1):50–68.PubMedCrossRef
33.
Jadresić L, Au H, Woodhouse C, Nitsch D. Pre-pregnancy obesity and risk of congenital abnormalities of the kidney and urinary tract (CAKUT)-systematic review, meta-analysis and ecological study. Pediatr Nephrol. 2021;36(1):119–32.PubMedCrossRef
34.
Macumber I, Schwartz S, Leca N. Maternal obesity is associated with congenital anomalies of the kidney and urinary tract in offspring. Pediatr Nephrol. 2017;32(4):635–42.PubMedCrossRef
35.
Arendt LH, Ramlau-Hansen CH, Lindhard MS, Henriksen TB, Olsen J, Yu Y, et al. Maternal overweight and obesity and genital anomalies in male offspring: a population-based Swedish cohort study. Paediatr Perinat Epidemiol. 2017;31(4):317–27.PubMedCrossRef
36.
Schneuer FJ, Nassar N. Maternal obesity and male genital anomalies: potential role of placental insufficiency and metabolic syndrome. Paediatr Perinat Epidemiol. 2017;31(5):e1–3.PubMedCrossRef
37.
Lassance L, Haghiac M, Minium J, Catalano P, Hauguel-de MS. Obesity-induced down-regulation of the mitochondrial translocator protein (TSPO) impairs placental steroid production. J Clin Endocrinol Metab. 2015;100(1):E11–8.PubMedCrossRef
38.
Blanco R, Colombo A, Suazo J. Maternal obesity is a risk factor for orofacial clefts: a meta-analysis. Br J Oral Maxillofac Surg. 2015;53(8):699–704.PubMedCrossRef
39.
Aagaard-Tillery KM, Flint Porter T, Malone FD, Nyberg DA, Collins J, Comstock CH, et al. Influence of maternal BMI on genetic sonography in the FaSTER trial. Prenat Diagn. 2010;30(1):14–22.PubMedCrossRef
40.
Dashe JS, McIntire DD, Twickler DM. Maternal obesity limits the ultrasound evaluation of fetal anatomy. J Ultrasound Med. 2009;28(8):1025–30.PubMedCrossRef
41.
Gupta VK, Adams JH, Heiser T, Iruretagoyena JI, Hoppe KK, Antony KM. Detailed fetal anatomic ultrasound examination duration and association with body mass index. Obstet Gynecol. 2019;134(4):774–80.PubMedCrossRef
42.
Yaqub M, Kelly B, Noble JA, Papageorghiou AT. The effect of maternal body mass index on fetal ultrasound image quality. Am J Obstet Gynecol. 2021;225(2):200–2.PubMedCrossRef
43.
Eastwood KA, Daly C, Hunter A, McCance D, Young I, Holmes V. The impact of maternal obesity on completion of fetal anomaly screening. J Perinat Med. 2017;45(9):1061–7.PubMedCrossRef
44.
Romary L, Sinkovskaya E, Ali S, Cunningham TD, Marwitz S, Heeze A, et al. The role of early gestation ultrasound in the assessment of fetal anatomy in maternal obesity. J Ultrasound Med. 2017;36(6):1161–8.PubMedCrossRef
45.
Majeed A, Abuhamad A, Romary L, Sinkovskaya E. Can ultrasound in early gestation improve visualization of fetal cardiac structures in obese pregnant women? J Ultrasound Med. 2019;38(8):2057–63.PubMedCrossRef
46.
Weatherborn M, McGuinness B, Ogamba MI, Leung K, Leftwich HK. Optimal timing of the second trimester fetal ultrasound in the obese gravida. J Matern Fetal Neonatal Med. 2022;35(14):2703–7.PubMedCrossRef
47.
Paladini D. Sonography in obese and overweight pregnant women: clinical, medicolegal and technical issues. Ultrasound Obstet Gynecol. 2009;33(6):720–9.PubMedCrossRef
48.
Abuhamad A. Ultrasound in obstetrics and gynecology: a practical approach 2014.
49.
Bak GS, Shaffer BL, Madriago E, Allen A, Kelly B, Caughey AB, et al. Impact of maternal obesity on fetal cardiac screening: which follow-up strategy is cost-effective? Ultrasound Obstet Gynecol. 2020;56(5):705–16.PubMedCrossRef
50.
Uhden M, Knippel AJ, Stressig R, Hammer R, Siegmann H, Froehlich S, et al. Impact of maternal obesity and maternal overweight on the detection rate of fetal heart defects and the image quality of prenatal echocardiography. Ultraschall Med. 2011;32(Suppl 2):E108–14.PubMedCrossRef
51.
Maxwell C, Glanc P. Imaging and obesity: a perspective during pregnancy. AJR Am J Roentgenol. 2011;196(2):311–9.PubMedCrossRef
52.
Garel C. Imaging the fetus: when does MRI really help? Pediatr Radiol. 2008;38(Suppl 3):S467–70.PubMedCrossRef
Metadaten
Titel
Congenital Anomalies in Women with Obesity
verfasst von
Katherine Pressman
Sarah Običan
Publikationsdatum
21.03.2023
Verlag
Springer US
Erschienen in
Current Obstetrics and Gynecology Reports / Ausgabe 2/2023
Elektronische ISSN: 2161-3303
DOI
https://doi.org/10.1007/s13669-023-00352-z

Weitere Artikel der Ausgabe 2/2023

Current Obstetrics and Gynecology Reports 2/2023 Zur Ausgabe

REVIEW

Preventing Adverse Cardiovascular Outcomes in Pregnancy Complicated by Obesity

REVIEW

Intrauterine Device Complications and Their Management

REVIEW

Infertility Treatment in Women with Obesity

REVIEW

Stroke in Pregnancy

REVIEW

Early Pregnancy Assessment Clinics: Expanding Patient-Centered and Equitable Early Pregnancy Care

REVIEW

Second Trimester Medication Abortion Regimens and the Mifepristone-Misoprostol Dosing Interval

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Alter der Mutter beeinflusst Risiko für kongenitale Anomalie

28.05.2024 Kinder- und Jugendgynäkologie Nachrichten

Welchen Einfluss das Alter ihrer Mutter auf das Risiko hat, dass Kinder mit nicht chromosomal bedingter Malformation zur Welt kommen, hat eine ungarische Studie untersucht. Sie zeigt: Nicht nur fortgeschrittenes Alter ist riskant.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen
Bildnachweise