- Home>
- Specialties>
- Women's Health>
- Summary and Comment
Maternal Diabetes, Not Obesity, Does the Damage
Pregestational diabetes was associated significantly with congenital anomalies; obesity alone was not.
More than one third of U.S. women are obese, and many adverse pregnancy outcomes are strongly associated with obesity. However, whether obesity raises risk for congenital anomalies is not clear. Investigators compiled data on maternal body-mass index (BMI) and incidence of major congenital anomalies in 42,000 singleton pregnancies in a university maternal care system during three time intervals: 1991 through 1994, 1995 through 1999, and 2000 through 2004.
Mean maternal weight, BMI, and proportion of women defined as obese rose with each successive time interval. During the entire study period, prevalence of major anomalies increased from 0.43% to 0.84%. Obesity was not independently associated with excess risk for congenital anomalies. Between the first and third time intervals, prevalence of pregestational diabetes almost tripled (increasing from 1.3% to 3.2%). Analysis adjusted for multiple variables showed that pregestational diabetes was associated with almost fourfold higher risk for congenital abnormalities. During the third time interval, 71% of congenital anomalies in offspring of obese women were attributable to maternal diabetes.
Comment: These results show that obesity itself does not seem to cause congenital anomalies. Obesity, however, does predispose women to diabetes — and diabetes is strongly associated with congenital anomalies. Clinicians should screen obese women of child-bearing age for diabetes (ideally, before conception) with fasting blood-sugar measurement so that maternal glycemic control can be achieved before fetal organogenesis begins.
Published in Journal Watch Women's Health February 25, 2010
Citation(s):
Biggio JR Jr et al. Fetal anomalies in obese women: The contribution of diabetes. Obstet Gynecol 2010 Feb; 115:290.
- Medline abstract (Free)
Reader Remarks:
Review and add to remarks on this article
- Maternal Diabetes, Not Obesity, Does the Damage
Abid Ahmed, RCMC, Yanbu, Saudi Arabia, 2 Mar 2010 1:54 PM EST
This is a very significant study endorsing the fact that it is the peri - conceptional glycemic control which is... [more]
Your Remark:
To ensure that your Reader Remark is not formatted as one long paragraph, precede new paragraphs with either a blank line or an indentation.