Moraes Carolina Leão de, Mendonça Carolina Rodrigues, Melo Natália Cruz E, Amaral Waldemar Naves do
Faculty of Medicine, Department of Obstetrics and Gynecology, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, GO, Brazil.
Paulista Medical School, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ginecol Obstet. 2019 May;41(5):280-290. doi: 10.1055/s-0039-1683971. Epub 2019 Apr 8.
To evaluate and compare the prevalence of structural congenital anomalies (CAs) according to maternal body mass index (BMI).
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 ≤ 0.05 considered statistically significant.
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; ≤ 0.004) and between anomalies of the lymphatic system in obese pregnant women (PR = 4.04, ≤ 0.000).
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.
根据孕妇体重指数（BMI）评估和比较结构性先天性异常（CAs）的患病率。
本横断面研究纳入了2014年11月至2016年1月期间通过形态学超声诊断为胎儿结构性CAs的孕妇。根据体重指数总值对孕妇的营养状况进行分类。孕妇被分为四组：低体重、体重正常、超重和肥胖。使用Stata/SE 12.0版（Stata公司，德克萨斯州大学站）进行统计分析，P值≤0.05被认为具有统计学意义。
共有223名孕妇的胎儿被诊断为CAs。低体重孕妇的结构性CAs患病率为20.18%，体重正常孕妇为43.50%，超重孕妇为22.87%，肥胖孕妇为13.45%。四组孕妇的中枢神经系统（CNS）异常和泌尿生殖系统异常患病率均较高。体重正常孕妇的多种异常之间（患病率比[PR]=1.65；P≤0.004）以及肥胖孕妇的淋巴系统异常之间（PR=4.04，P≤0.000）存在正相关。
所有BMI类别中，CNS和泌尿生殖系统异常的患病率均较高。肥胖妊娠与淋巴系统异常有关。因此，无论孕妇BMI如何，筛查和识别CAs的危险因素都很重要。我们的研究结果强化了与孕妇讨论母体营养及其对胎儿发育和新生儿结局影响的重要性。
