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Chambers HN, Caris E, Conwell J, Edwards LA, Hulse JE, Lewin M, Pinto NM, Wolfe E, Arya B. Suboptimal Imaging on Obstetric Ultrasound Should Prompt Early Referral for Fetal Echocardiography. Pediatr Cardiol 2024:10.1007/s00246-024-03495-9. [PMID: 38831151 DOI: 10.1007/s00246-024-03495-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/08/2024] [Indexed: 06/05/2024]
Abstract
Recent studies suggest that suboptimal cardiac imaging on routine obstetric anatomy ultrasound (OB-scan) is not associated with a higher risk for congenital heart disease (CHD) and, therefore, should not be an indication for fetal echocardiography (F-echo). We aim to determine the incidence of CHD in patients referred for suboptimal imaging in a large catchment area, including regions that are geographically distant from a tertiary care center. We conducted a retrospective chart review of patients referred to Seattle Children's Hospital (SCH) and SCH Regional Cardiology sites (SCH-RC) from 2011 to 2021 for F-echo with the indication of suboptimal cardiac imaging by OB-scan. Of 454 patients referred for suboptimal imaging, 21 (5%) of patients were diagnosed with CHD confirmed on postnatal echo. 10 patients (2%) required intervention by age one. Mean GA at F-echo was significantly later for suboptimal imaging compared to all other referral indications (27.5 ± 3.9 vs 25.2 ± 5.2 weeks, p < 0.01). Mean GA at F-echo was also significantly later at SCH-RC compared to SCH (29.2 ± 4.6 vs 24.2 ± 2.9 weeks; p < 0.01). In our experience, CHD in patients referred for suboptimal imaging is higher (5%) than previously described, suggesting that routine referral for is warranted. Furthermore, while suboptimal imaging was associated with a delayed F-echo compared to other indications, this delay was most striking for those seen at regional sites. This demonstrates a potential disparity for these patients and highlights opportunities for targeted education in cardiac assessment for primary providers in these regions.
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Affiliation(s)
- Hailey N Chambers
- Seattle Children's Hospital, University of Washington Medical Center, OC.7.830, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA.
| | | | - Jeffrey Conwell
- Seattle Children's Hospital, University of Washington Medical Center, Seattle, WA, USA
| | | | - J Eddie Hulse
- Seattle Children's Hospital, University of Washington Medical Center, Seattle, WA, USA
| | - Mark Lewin
- Seattle Children's Hospital, University of Washington Medical Center, Seattle, WA, USA
| | - Nelangi M Pinto
- Seattle Children's Hospital, University of Washington Medical Center, Seattle, WA, USA
| | - Elana Wolfe
- Seattle Children's Hospital, University of Washington Medical Center, Seattle, WA, USA
| | - Bhawna Arya
- Seattle Children's Hospital, University of Washington Medical Center, Seattle, WA, USA
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2
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Buskmiller C, Huntley E, Blackburn B, Sanchez D, Hernandez-Andrade E. Completion of Fetal Anatomy Evaluations in Women With Body Mass Index ≥ 50 kg/m 2. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2839-2844. [PMID: 37647313 DOI: 10.1002/jum.16323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES As maternal body mass index (BMI) increases, fetal anatomy ultrasound becomes more challenging, less sensitive, and less likely to be complete. We sought to report our experience of incomplete evaluation of anatomy in patients with BMI of 50 kg/m2 or greater. METHODS This is a retrospective cohort of singleton gestations in mothers with BMI of 50 kg/m2 or greater, undergoing anatomy evaluations between 2017 and 2021 at 9 maternal-fetal-medicine sites in Houston, TX. Patient variables and scan results were collected throughout pregnancy to provide a longitudinal assessment of the primary outcome, completion rate (percent of all scans which optimally captured 24 American Institute of Ultrasound in Medicine-recommended images). Secondary outcomes included the rate of optimal capture of each individual structure. RESULTS In total, 293 patients with BMI ≥50 kg/m2 were identified. Only 28% of initial scans were complete, but over the entire pregnancy, a complete anatomic evaluation was achieved in 76% of women, largely due to weekly ultrasounds done for antenatal testing later in pregnancy. Neither BMI, placental location, nor amniotic fluid volume affected completion rate. The most difficult views are the outflow tracts, 4-chamber view, and spine. CONCLUSIONS One quarter of women with BMI of 50 kg/m2 or greater will not have a complete fetal anatomic evaluation by the end of pregnancy, since even basic fetal anatomic views are technically challenging to complete. Solutions deserve further attention, and may include first trimester imaging, transvaginal imaging, and optimization of ultrasound machine settings.
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Affiliation(s)
- Cara Buskmiller
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
| | - Erin Huntley
- Department of Obstetrics, Gynecology and Reproductive Sciences (UTHealth), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Bonnie Blackburn
- Department of Obstetrics, Gynecology and Reproductive Sciences (UTHealth), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Darren Sanchez
- Department of Obstetrics, Gynecology and Reproductive Sciences (UTHealth), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Edgar Hernandez-Andrade
- Department of Obstetrics, Gynecology and Reproductive Sciences (UTHealth), McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA
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3
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Pressman K, Običan S. Congenital Anomalies in Women with Obesity. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2023. [DOI: 10.1007/s13669-023-00352-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Fetal Risks and Morbidity in Pregnant Individuals with Obesity. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2023. [DOI: 10.1007/s13669-023-00347-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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5
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Pimentel VM, Kreditor E, Ferrante A, Figueroa R, Wakefield DB, Crowell R. Perception of the impact of maternal weight on pregnancy outcomes in overweight and obese women. J Matern Fetal Neonatal Med 2022; 35:10676-10684. [PMID: 36510343 DOI: 10.1080/14767058.2022.2155038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The purpose of this study was to assess and compare knowledge, self-awareness, and accuracy of perceived risks and weight status among overweight and obese women. METHODS This study was a secondary analysis of a cross-sectional questionnaire study of overweight and obese pregnant women who sought a routine first-trimester screening ultrasound. Those with a pre-pregnancy body mass index (BMI) ≥25 kg/m2 (calculated using self-reported height and weight) were included. Perceived associations between estimated weight category and risk of pregnancy complications were assessed and compared in the overweight and obese groups. The perceived weight category was compared to an estimated weight category. A logistic regression identified the demographic and medical factors associated with correct identification of risk factors. RESULTS A total of 169 participants (88 overweight; 81 obese) were included. Most participants believed their weight did not impact the ultrasound detection of a fetal malformation (92.1% overweight vs. 55.6% obese, p < .01). Few participants associated their weight with pregnancy-related problems (6.8% overweight vs. 24.7% obese, p < .01). Most participants did not associate their weight with specific maternal complications (72.7% overweight vs. 45.7% obese, p < .01) and fetal complications (83.0% overweight vs. 71.6% obese, p = .08). More obese than overweight women underestimated their weight category (64.4% vs 41.3% overweight, p = .01). Women who correctly estimated their weight status, non-Hispanic participants, and those with a history of depression or at least one maternal co-morbidity were more likely to associate their weight with increased risk for pregnancy-related problems. CONCLUSION Although more obese than overweight women associated excess weight with pregnancy complications, both groups underestimated the impact on their pregnancies. Targeted educational programs are needed to improve the risk perception of these populations prior to pregnancy with the goal of improving their weight statuses and pregnancy outcomes.
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Affiliation(s)
- Veronica Maria Pimentel
- Department of Obstetrics and Gynecology, St. Francis Hospital and Medical Center, Trinity Health Of New England, Hartford, CT, USA.,Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT, USA
| | - Elina Kreditor
- Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT, USA
| | - Anthony Ferrante
- Department of Obstetrics and Gynecology, St. Francis Hospital and Medical Center, Trinity Health Of New England, Hartford, CT, USA
| | - Reinaldo Figueroa
- Department of Obstetrics and Gynecology, St. Francis Hospital and Medical Center, Trinity Health Of New England, Hartford, CT, USA.,Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT, USA
| | | | - Rebecca Crowell
- Research Development Office. St. Francis Hospital and Medical Center, Trinity Health of New England, Hartford, CT
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Kent L, Cardwell C, Young I, Eastwood KA. Trends in maternal body mass index in Northern Ireland: a cross-sectional and longitudinal study. Fam Med Community Health 2021; 9:fmch-2021-001310. [PMID: 34949675 PMCID: PMC8710425 DOI: 10.1136/fmch-2021-001310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives Explore (1) associations between maternal body mass index (BMI), demographic and clinical characteristics, (2) longitudinal trends in BMI, (3) geographical distributions in prevalence of maternal overweight and obesity. Design Retrospective population-based study. Setting Linked, anonymised, routinely collected healthcare data and official statistics from Northern Ireland. Participants All pregnancies in Northern Ireland (2011–2017) with BMI measured at ≤16 weeks gestation. Methods Analysis of variance and χ2 tests were used to explore associations. Multiple linear regression was used to explore longitudinal trends and spatial visualisation illustrated geographical distribution. Main outcomes are prevalence of overweight (BMI ≥25 kg/m2) and obesity (BMI ≥30 kg/m2). Results 152 961 singleton and 2362 multiple pregnancies were included. A high prevalence of maternal overweight and obesity in Northern Ireland is apparent (singleton: 52.4%; multiple: 48.3%) and is increasing. Obesity was positively associated with older age, larger numbers of previous pregnancies and unplanned pregnancy (p<0.001). BMI category was also positively associated with unemployment (35% in obese class III vs 22% in normal BMI category) (p<0.001). Higher BMI categories were associated with increased rate of comorbidities, including hypertension (normal BMI: 1.8% vs obese III: 12.4%), diabetes mellitus (normal BMI: 0.04% vs obese III: 1.29%) and mental ill-health (normal BMI: 5.0% vs obese III: 11.8%) (p<0.001). Prevalence of maternal obesity varied with deprivation (most deprived: 22.8% vs least deprived: 15.7%) (p<0.001). Low BMI was associated with age <20 years, nulliparity, unemployment and mental ill-health (p<0.001). Conclusions The prevalence of maternal BMI >25 kg/m2 is increasing over time in Northern Ireland. Women are entering pregnancy with additional comorbidities likely to impact their life course beyond pregnancy. This highlights the need for prioritisation of preconception and inter-pregnancy support for management of weight and chronic conditions.
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Affiliation(s)
- Lisa Kent
- Administrative Data Research Centre Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Christopher Cardwell
- Institute of Clinical Science, Block B, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ian Young
- Institute of Clinical Science, Block B, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Kelly-Ann Eastwood
- Institute of Clinical Science, Block B, Centre for Public Health, Queen's University Belfast, Belfast, UK .,Fetal Medicine Unit, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Lempersz C, Noben L, Clur SAB, van den Heuvel E, Zhan Z, Haak M, Oei SG, Vullings R, van Laar JOEH. The electrical heart axis of the fetus between 18 and 24 weeks of gestation: A cohort study. PLoS One 2021; 16:e0256115. [PMID: 34914710 PMCID: PMC8675734 DOI: 10.1371/journal.pone.0256115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/31/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction A fetal anomaly scan in mid-pregnancy is performed, to check for the presence of congenital anomalies, including congenital heart disease (CHD). Unfortunately, 40% of CHD is still missed. The combined use of ultrasound and electrocardiography might boost detection rates. The electrical heart axis is one of the characteristics which can be deduced from an electrocardiogram (ECG). The aim of this study was to determine reference values for the electrical heart axis in healthy fetuses around 20 weeks of gestation. Material and methods Non-invasive fetal electrocardiography was performed subsequent to the fetal anomaly scan in pregnant women carrying a healthy singleton fetus between 18 and 24 weeks of gestation. Eight adhesive electrodes were applied on the maternal abdomen including one ground and one reference electrode, yielding six channels of bipolar electrophysiological measurements. After removal of interferences, a fetal vectorcardiogram was calculated and then corrected for fetal orientation. The orientation of the electrical heart axis was determined from this normalized fetal vectorcardiogram. Descriptive statistics were used on normalized cartesian coordinates to determine the average electrical heart axis in the frontal plane. Furthermore, 90% prediction intervals (PI) for abnormality were calculated. Results Of the 328 fetal ECGs performed, 281 were included in the analysis. The average electrical heart axis in the frontal plane was determined at 122.7° (90% PI: -25.6°; 270.9°). Discussion The average electrical heart axis of healthy fetuses around mid-gestation is oriented to the right, which is, due to the unique fetal circulation, in line with muscle distribution in the fetal heart.
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Affiliation(s)
- Carlijn Lempersz
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands.,Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
| | - Lore Noben
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands.,Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
| | - Sally-Ann B Clur
- Department of Pediatric Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Edwin van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Zhouzhao Zhan
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Monique Haak
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - S Guid Oei
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands.,Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Rik Vullings
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Judith O E H van Laar
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands.,Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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8
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Poehlmann JR, Timmel A, Adams JH, Gupta VK, Rhoades JS, Iruretagoyena JI, Hoppe KK, Antony KM. A Matter of Time: Does Gestational Age Affect the Duration of the Fetal Anatomic Survey? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1763-1770. [PMID: 33155692 DOI: 10.1002/jum.15554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/24/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To assess the average duration of detailed fetal anatomic surveys in pregnancy in relation to gestational age (GA) and the maternal body mass index (BMI) to determine optimal timing of the examination. METHODS This was a retrospective cohort study of gravidae presenting for detailed fetal anatomic examinations between January 1, 2010, and June 30, 2017. After excluding examinations expected to have longer duration (ie, multifetal, major fetal anomalies), there were a total of 6522 examinations performed between GAs of 18 weeks 0 days and 22 weeks 0 days. Women were grouped by BMI, and results were analyzed by logistic regression. RESULTS Gravidae of normal weight (BMI, 18.5-24.9 kg/m2 ) had a decrease of 47.47 seconds of the examination time with each increasing week of gestation (P = .036). Overweight (BMI, 25-29.9 kg/m2 ) gravidae similarly had a decrease of 66.31 seconds of the examination time with each additional week of gestation (P = .017). Underweight (BMI, 8.5 kg/m2 ) and obese (BMI, ≥30 kg/m2 ) gravidae did not have differences in the examination time with increasing GA. Increases in suboptimal examinations were noted with an increasing BMI (P < .001). There was a decreased frequency of suboptimal examinations in obese gravidae with a BMI of 40 kg/m2 or higher with increasing GA (P = .037). CONCLUSIONS The duration of detailed fetal anatomic examinations decreased with increasing GA in normal-weight and overweight gravidae but not in obese gravidae. Performing the anatomy scan earlier in class I and II obese gravidae (BMI, 30-40 kg/m2 ) may enable improved pregnancy management options without increasing the examination duration or likelihood of a suboptimal evaluation.
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Affiliation(s)
- John R Poehlmann
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ainsley Timmel
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jacquelyn H Adams
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Vivek K Gupta
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Janine S Rhoades
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - J Igor Iruretagoyena
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kara K Hoppe
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kathleen M Antony
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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McAuliffe FM, Killeen SL, Jacob CM, Hanson MA, Hadar E, McIntyre HD, Kapur A, Kihara AB, Ma RC, Divakar H, Hod M. Management of prepregnancy, pregnancy, and postpartum obesity from the FIGO Pregnancy and Non-Communicable Diseases Committee: A FIGO (International Federation of Gynecology and Obstetrics) guideline. Int J Gynaecol Obstet 2020; 151 Suppl 1:16-36. [PMID: 32894590 PMCID: PMC7590083 DOI: 10.1002/ijgo.13334] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, National Maternity Hospital, University College Dublin, Dublin, Ireland
| | - Chandni Maria Jacob
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Mark A Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK
| | - Eran Hadar
- Maternal-Fetal Medicine Unit, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - H David McIntyre
- Mater Research, The University of Queensland, South Brisbane, Qld, Australia
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Anne B Kihara
- African Federation of Obstetricians and Gynaecologists, Khartoum, Sudan.,Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Moshe Hod
- Mor Comprehensive Women's Health Care Center, Tel Aviv, Israel.,FIGO Pregnancy and Non-Communicable Diseases Committee, International Federation of Gynecology and Obstetrics, London, UK
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10
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Xiao D, Qu Y, Huang L, Wang Y, Li X, Mu D. Association between maternal overweight or obesity and cerebral palsy in children: A meta-analysis. PLoS One 2018; 13:e0205733. [PMID: 30325944 PMCID: PMC6191132 DOI: 10.1371/journal.pone.0205733] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/01/2018] [Indexed: 01/23/2023] Open
Abstract
CONTEXT There is no consensus regarding the association between maternal obesity or overweight and cerebral palsy (CP) in children. OBJECTIVES To investigate whether maternal obesity or overweight is associated with CP and identify the factors that explain the differences in the study results. DATA SOURCES We conducted a meta-analysis of studies published in English with titles or abstracts that discussed the relationships between maternal obesity or overweight and CP before August 23, 2017, using Ovid Medline, EMBASE and Web of Science. STUDY SELECTION Of 2699 initially identified studies, 8 studies that addressed the association between maternal obesity and CP met our final inclusion criteria. DATA EXTRACTION Information from the individual studies was abstracted using standardized forms by 2 independent observers who were blinded to the authors' names and journal titles. DATA SYNTHESIS According to a random effects model, maternal overweight was significantly associated with CP in offspring [RR = 1.29 (95% CI, 1.04-1.60), heterogeneity (I2 = 45.5%, P = 0.103)]; maternal obesity was significantly associated with CP in offspring [RR = 1.45 (95% CI, 1.25-1.69), heterogeneity (I2 = 24.1%, P = 0.253)]; and maternal obesity III was significantly associated with CP in offspring [RR = 2.25 (95% CI, 1.82-2.79), heterogeneity (I2 = 0%, P = 0.589)]. However, maternal underweight was not significantly associated with CP in offspring [RR = 1.11 (95% CI, 0.88-1.38), low heterogeneity (I2 = 0%, P = 0.435)]. Factors that explained the differences in the meta-analysis results included study design, study location, and whether individual studies adjusted for potential confounders. CONCLUSION This study suggests that maternal obesity and overweight increase the risk of CP in offspring. Further studies are required to confirm these results and determine the influence of variables across studies.
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Affiliation(s)
- Dongqiong Xiao
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Yi Qu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Lan Huang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Yan Wang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Xihong Li
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Dezhi Mu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
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11
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Preen C, Munn Z, Raju S, Flack N. Second trimester ultrasound detection of fetal anomalies in the obese obstetrical population: a systematic review protocol. ACTA ACUST UNITED AC 2018; 16:328-335. [PMID: 29419619 DOI: 10.11124/jbisrir-2017-003505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this review is to identify, appraise and synthesize the best available evidence on the impact of maternal obesity on mid second trimester ultrasound detection of fetal anomalies in pregnancy.
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Affiliation(s)
- Christina Preen
- The Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.,Lyell McEwin Hospital, SA Health, Adelaide, Australia
| | - Zachary Munn
- The Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Smita Raju
- Royal Adelaide Hospital, SA Health, Adelaide, Australia
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