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  • Original Article
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Pediatrics

Maternal overweight and obesity and risk of congenital heart defects in offspring

International Journal of Obesity volume 38, pages 878–882 (2014)Cite this article

Subjects

A Corrigendum to this article was published on 10 June 2014

Abstract

Objective:

Obesity is a risk factor for congenital heart defects (CHDs), but whether risk is independent of abnormal glucose metabolism remains unknown. Data on whether overweight status increases the risk are also conflicting.

Research Design and Methods:

We included 121 815 deliveries from a cohort study, the Consortium on Safe Labor (CSL), after excluding women with pregestational diabetes as recorded in the electronic medical record. CHD was identified via medical record discharge summaries. Adjusted odds ratios (ORs) for any CHD were calculated for prepregnancy body mass index (BMI) categories of overweight (25–<30 kg m−2), obese (30–<40 kg m−2) and morbidly obese (⩾40 kg m−2) compared with normal weight (18.5–<25 kg m−2) women, and for specific CHD with obese groups combined (⩾30 kg m−2). A subanalysis adjusting for oral glucose tolerance test (OGTT) results where available was performed as a proxy for potential abnormal glucose metabolism present at the time of organogenesis.

Results:

There were 1388 (1%) infants with CHD. Overweight (OR=1.15, 95% confidence interval (95% CI): 1.01–1.32), obese (OR=1.26, 95% CI: 1.09–1.44) and morbidly obese (OR=1.34, 95% CI: 1.02–1.76) women had greater OR of having a neonate with CHD than normal weight women (P<0.001 for trend). Obese women (BMI⩾30 kg m−2) had higher OR of having an infant with conotruncal defects (OR=1.34, 95% CI: 1.04–1.72), atrial septal defects (OR=1.22, 95% CI: 1.04–1.43) and ventricular septal defects (OR=1.38, 95% CI: 1.06–1.79). Being obese remained a significant predictor of CHD risk after adjusting for OGTT.

Conclusion:

Increasing maternal weight class was associated with an increased risk for CHD. In obese women, abnormal glucose metabolism did not completely explain the increased risk for CHD; the possibility that other obesity-related factors are teratogenic requires further investigation.

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Acknowledgements

Institutions involved in the Consortium include, in alphabetical order: Baystate Medical Center, Springfield, MA; Cedars-Sinai Medical Center Burnes Allen Research Center, Los Angeles, CA; Christiana Care Health System, Newark, DE; Georgetown University Hospital, MedStar Health, Washington, DC; Indiana University Clarian Health, Indianapolis, IN; Intermountain Healthcare and the University of Utah, Salt Lake City, Utah; Maimonides Medical Center, Brooklyn, NY; MetroHealth Medical Center, Cleveland, OH; Summa Health System, Akron City Hospital, Akron, OH; The EMMES Corporation, Rockville, MD (Data Coordinating Center); University of Illinois at Chicago, Chicago, IL; University of Miami, Miami, FL; and University of Texas Health Science Center at Houston, Houston, Texas. The named authors alone are responsible for the views expressed in this manuscript, which does not necessarily represent the decisions or the stated policy of the NICHD. JB, SKL, JT and JM were supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health. The data included in this paper were obtained from the Consortium on Safe Labor, which was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, through Contract No. HHSN267200603425C.

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Authors and Affiliations

  1. Division of Intramural Population Health Research, Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA

    J Brite, S K Laughon & J Mills

  2. Epidemiology and Biostatistics, CUNY School of Public Health at Hunter College, New York, NY, USA

    J Brite

  3. CUNY Institute for Demographic Research (CIDR), New York, NY, USA

    J Brite

  4. Division of Cardiovascular Sciences, Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, MD, USA

    J Troendle

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  1. J Brite
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Correspondence to S K Laughon.

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Supplementary Information accompanies this paper on International Journal of Obesity website

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Brite, J., Laughon, S., Troendle, J. et al. Maternal overweight and obesity and risk of congenital heart defects in offspring. Int J Obes 38, 878–882 (2014). https://doi.org/10.1038/ijo.2013.244

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