Document Detail

Spina bifida phenotypes in infants or fetuses of obese mothers.
MedLine Citation:
PMID:  10777833     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A twofold or greater risk of neural tube defect (NTD)-affected pregnancy has been associated with prepregnant obesity, where obesity was defined as body mass index (BMI) of >29 kg/m(2). Risks have been more elevated for spina bifida than for anencephaly. METHODS: We investigated whether finer phenotypic classifications of spina bifida, in combination with other factors, were associated with a BMI of >29 kg/m(2). Data were derived from a case-control study of fetuses and infants with NTDs among 1989-1991 California births. Interviews were conducted with mothers of 277 spina bifida cases and 517 nonmalformed controls. RESULTS: Women with a BMI of >29 kg/m(2) compared with those </=29 kg/m(2) revealed an odds ratio (OR) of 2.2 (95% confidence interval [95% CI] = 1.4-3. 3) for spina bifida in their infants and fetuses. Elevated risks were observed for each spina bifida subphenotype, and risks varied by subphenotype: open spina bifida, OR = 2.0 (1.2-3.1); closed (skin-covered), 3.3 (1.4-7.5); isolated, 2.2 (1.4-3.4); nonisolated, 1.9 (0.9-4.2); high, 4.5 (2.1-9.6); low, 1.9 (1.2-2.9); open/isolated/high, 7.1 (2.8-18.1); and open/isolated/low, 1.8 (1. 1-3.1). Risks were higher among female infants/fetuses and foreign-born Latinas, and for some phenotypes the risks were quite large, e.g., OR = 8.3 (2.9-23.6) for "closed" spina bifida among female infants/fetuses whose mothers were >29 kg/m(2) compared with males whose mothers were </=29 kg/m(2). Maternal periconceptional vitamin use was not observed to influence risk as greatly across phenotypes. CONCLUSIONS: The observed pathogenetic heterogeneity of prepregnant obesity and spina bifida risks suggests that there are likely to be several biologic mechanisms underlying the association.
G M Shaw; K Todoroff; R H Finnell; E J Lammer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Teratology     Volume:  61     ISSN:  0040-3709     ISO Abbreviation:  Teratology     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-06-01     Completed Date:  2000-06-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0153257     Medline TA:  Teratology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  376-81     Citation Subset:  IM    
Copyright Information:
Copyright 2000 Wiley-Liss, Inc.
March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Emeryville, California 94608, USA.
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MeSH Terms
Body Mass Index
Case-Control Studies
Infant, Newborn
Odds Ratio
Risk Factors
Sex Factors
Spinal Dysraphism / ethnology,  etiology*

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