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The Journal of Maternal-Fetal & Neonatal Medicine Volume 35, 2022 - Issue 25
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Review Article

Risk of neural tube defects according to maternal body mass index: a systematic review and meta-analysis

Flaminia Venaa Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, ItalyCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-8187-3580
ORCID Icon,
Valentina D'Ambrosioa Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, ItalyORCID Iconhttps://orcid.org/0000-0002-3820-1030
ORCID Icon,
Vanessa Paladinia Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
,
Enrica Saluzzia Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
,
Daniele Di Mascioa Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
,
Chiara Boccherinia Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
,
Lorenzo Spinielloa Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
,
Alessandro Mondoa Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
,
Antonio Pizzutib Department of Experimental Medicine, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
&
Antonella Giancottia Department of Maternal and Child Health and Urologynecological Sciences, Sapienza University of Rome, Umberto I Hospital, Rome, Italy
 show all
Pages 7296-7305 | Received 24 Apr 2021, Accepted 20 Jun 2021, Published online: 05 Jul 2021
 
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Abstract

Introduction

The aim of our systematic review and meta-analysis was to evaluate the risk of neural tube defects (NTDs) according to the pre-pregnancy body mass index.

Materials and methods

Electronic databases were searched (MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID, and Cochrane Library). Selection criteria included prospective and retrospective cohort studies reporting the prevalence of fetal NTDs in obese, overweight, and underweight pregnant women. Odds ratios (ORs) comparing risk among these subsets of pregnancies with normal weight mothers were determined with 95% confidence intervals (CI). The evaluated outcome was the association between maternal underweight, overweight, and obesity and the risk of NTDs.

Results

We included ten studies published between 2000 and 2017, including underweight, overweight, and obese pregnant women with fetal NTD (cases) and pregnant women with recommended BMI with fetal NTD (controls). Compared with normal BMI women, obese mothers were at significantly higher risk of fetal NTDs (0.53 vs. 0.33%; OR 1.62 95% CI 1.32–1.99, p < .0001), while no difference for the risk of NTDs was found when comparing overweight (0.34 vs. 0.32%; OR 1.09 95% CI 0.92–1.3, p = .3) and underweight (0.65 vs. 0.24%; OR 1.34 95% CI 0.73–2.47, p = .34) with normal weight pregnant women.

Discussion

Obese pregnant women are at significantly higher risk NTDs, while no significant difference has been found in overweight and underweight pregnant women.

    Key message

  •  Obese pregnant women are at significantly higher risk of NTDs, such as spina bifida compared with normal weight women. No difference was found when comparing overweight and underweight with normal weight women.

Disclosure statement

The authors report no conflict of interest.

Author contributions

FV: conception, planning, analysis, and writing. VD: planning, analysis, and writing. VP, ES, and DDM: conception, planning, analysis, and writing. CB, LS, and AM: conception, planning, and writing. AP and AG: conception, planning, and writing.

Data availability statement

Data are available within the article or its supplementary material.

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