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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >Impact of maternal body mass index on the antenatal detection of congenital anomalies
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Impact of maternal body mass index on the antenatal detection of congenital anomalies

机译：孕产妇体重指数对先天性异常产前检测的影响

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摘要

Objective To investigate the association between maternal body mass index (BMI) and antenatal ultrasound detection of congenital anomalies. Design Population-based register study. Setting North of England (UK). Population All pregnancies (n = 3096) associated with a congenital anomaly notified to the Northern Congenital Abnormality Survey (NorCAS) during 2006-2009. Cases with chromosomal and teratogenic anomalies (n = 611) or without information on antenatal scanning (n = 4) were excluded. Methods Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for antenatal detection according to maternal BMI categories were estimated using logistic regression. Main outcome measures For all anomalies combined, cases were defined as 'detected' if any congenital anomaly was suspected antenatally. Organ system-specific anomalies were defined as detected if an anomaly of the correct system was suspected. Results Antenatal detection of any anomaly occurred in 1146 of 2483 (46.2%) cases with normal karyotype. The odds of detection were significantly decreased in obese (BMI ≥ 30 kg/m 2) women compared with women of recommended BMI (18.5-24.9 kg/m 2; aOR, 0.77; 95% CI, 0.60-0.99; P = 0.046). Cardiovascular system anomalies were suspected antenatally in 109 of 945 (11.5%) cases. The odds of detecting a cardiovascular anomaly were significantly greater in underweight women (BMI 18.5 kg/m 2) than in women of recommended BMI (aOR, 2.95; 95% CI, 1.13-7.70; P = 0.027). There was no association between BMI and detection in any other organ system or between BMI and termination of pregnancy for fetal anomaly. Conclusions Antenatal ultrasound detection of a congenital anomaly is decreased in obese pregnant women. This has implications for the scanning and counselling of obese women.
机译：目的探讨孕妇体重指数（BMI）与先天性异常的产前超声检查之间的关系。设计基于人口的登记研究。设置在英格兰北部（英国）。人口2006年至2009年间，向北部先天异常调查（NorCAS）通报的与先天异常有关的所有怀孕（n = 3096）。排除了具有染色体和畸胎异常（n = 611）或没有产前扫描信息（n = 4）的病例。方法采用logistic回归方法，根据孕妇的BMI类别，评估经调整的比值比（aOR）和95％置信区间（CIs），以进行产前检测。主要结局指标对于所有合并的异常，如果在产前怀疑有任何先天性异常，则将病例定义为“检出”。如果怀疑是正确系统的异常，则将检测到的器官系统特定异常定义为。结果2483例核型正常的病例中有1146例发生产前检查，发现异常。与推荐的BMI（18.5-24.9 kg / m 2; aOR，0.77; 95％CI，0.60-0.99; P = 0.046）相比，肥胖（BMI≥30 kg / m 2）妇女的检出几率显着降低。 945名患者中有109名（11.5％）产前怀疑有心血管系统异常。体重过轻的女性（BMI <18.5 kg / m 2）发现心血管异常的几率明显高于推荐的BMI女性（aOR为2.95; 95％CI为1.13-7.70; P = 0.027）。 BMI与任何其他器官系统的检测之间没有关联，或者BMI与胎儿异常终止妊娠之间没有关联。结论肥胖孕妇的产前超声检查减少了先天性异常。这对肥胖妇女的扫描和咨询具有影响。

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