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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 12 Sep 2009
Modified on : 12 Sep 2009

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Bibliographical entry (without author) :

Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA. 2009 Feb 11;301(6):636-50. PMID: 19211471

Author(s) :

Stothard KJ, Tennant PW, Bell R, Rankin J.

Year of publication :


URL(s) :…

Résumé (français)  :

L’obésité maternelle, un risque pour le foetus

Plusieurs études ont montré que l’obésité des femmes augmente le risque
de développer des complications pendant la grossesse ainsi que celui
d’accouchement difficile. Une méta-analyse parue dans le /Jama /montre
en plus que l’obésité maternelle accroît le risque de malformation

L’obésité a des répercussions significatives sur le déroulement des
grossesses. Elle accroît le risque de diabète gestationnel et
d’hypertension chez la mère ou encore l’incidence d’accouchement par
césarienne. Mais l’obésité pourrait également augmenter le risque
d’anomalie congénitale chez le foetus. C’est ce qu’a voulu vérifier une
équipe anglaise en passant en revue toutes les études observationnelles
sur le poids ou l’indice de masse corporelle des femmes enceintes et les
données d’anomalies congénitales correspondantes.

Dix-huit études ont finalement été référencées pour cette méta-analyse.
Elles montrent que le risque d’anomalie congénitale reste faible mais
est significativement accru chez les femmes obèses par rapport aux
femmes de poids normal. Ces problèmes concernent le tube neural (OR :
2,24), le système cardiovasculaire (OR : 1,30), la fermeture du palais
et de la lèvre (OR : 1,20) ou encore la taille des membres (OR : 1,34).
Les fœtus présentent également un risque accru d’hydrocéphalie (OR :
1,68), d’atrésie anorectale (OR : 1,48) et d’anomalie septale (OR :
1,20). En revanche, l’incidence des gastrochisis était réduite de façon
importante chez les nouveaux-nés de mères obèses (OR : 0,17).

Traduction : Marie Lestelle (Paris)

Abstract (English)  :

CONTEXT: Evidence suggests an association between maternal obesity and some congenital anomalies.

OBJECTIVE: To assess current evidence of the association between maternal overweight, maternal obesity, and congenital anomaly.

DATA SOURCES: MEDLINE, EMBASE, CINAHL, and Scopus (January 1966 through May 2008) were searched for English-language studies using a list of keywords. Reference lists from relevant review articles were also searched.

STUDY SELECTION: Observational studies with an estimate of prepregnancy or early pregnancy weight or body mass index (BMI) and data on congenital anomalies were considered. Of 1944 potential articles, 39 were included in the systematic review and 18 in the meta-analysis. Data Extraction and Synthesis Information was extracted on study design, quality, participants, congenital anomaly groups and subtypes, and risk estimates. Pooled odds ratios (ORs) comparing risk among overweight, obese, and recommended-weight mothers (defined by BMI) were determined for congenital anomaly groups and subtypes for which at least 150 cases had been reported in the literature.

RESULTS: Pooled ORs for overweight and obesity were calculated for 16 and 15 anomaly groups or subtypes, respectively. Compared with mothers of recommended BMI, obese mothers were at increased odds of pregnancies affected by neural tube defects (OR, 1.87; 95% confidence interval [CI], 1.62-2.15), spina bifida (OR, 2.24; 95% CI, 1.86-2.69), cardiovascular anomalies (OR, 1.30; 95% CI, 1.12-1.51), septal anomalies (OR, 1.20; 95% CI, 1.09-1.31), cleft palate (OR, 1.23; 95% CI, 1.03-1.47), cleft lip and palate (OR, 1.20; 95% CI, 1.03-1.40), anorectal atresia (OR, 1.48; 95% CI, 1.12-1.97), hydrocephaly (OR, 1.68; 95% CI, 1.19-2.36), and limb reduction anomalies (OR, 1.34; 95% CI, 1.03-1.73). The risk of gastroschisis among obese mothers was significantly reduced (OR, 0.17; 95% CI, 0.10-0.30).

CONCLUSIONS: Maternal obesity is associated with an increased risk of a range of structural anomalies, although the absolute increase is likely to be small. Further studies are needed to confirm whether maternal overweight is also implicated.

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Keywords :

➡ pathologies of newborn ; public health ; foetus growth ; maternal weight

Author of this record :

Bernard Bel — 12 Sep 2009

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