Associations of maternal pre-pregnancy overweight and obesity with congenital heart disease in offsprings:A large sample retrospective cohort study in Kunshan of Jiangsu Province
Objective To evaluate the associations of maternal pre-pregnancy body mass index(BMI)with congenital heart disease(CHD)and its sub-types in offsprings.Methods In this retrospective cohort study,we analyzed the maternal data of 19992 women in Kunshan city with more than five-time antenatal examination records in local maternal hospitals and their live newborns from the Maternal and Child Care Information System of Jiangsu Province(from Jan.2019 to Oct.2021).Maternal pre-pregnancy BMI,antenatal examination information and delivery data were all collected via the system.CHD outcomes were obtained by the newborn CHD dual-index screening programs and cardiac ultrasound test at 3 month-old,which were divided into groups concerning maternal BMI before pregnancy according to the definitions for the Chinese population.Multivariate generalized linear models were used to analyze the relationship between maternal BMI befare pregnancy and CHD in offsprings and to estimate adjusted risk ratios(aRRs)and 95％confidence intervals(CIs).Results A total of 280 CHD cases(including 23 complex CHD cases)were screened among 19992 leveraged pregnant women.High maternal BMI before pregnancy increased the risk of CHD in offsprings(unadjusted RR 1.04,95％CI 1.01-1.08;P＜0.001).The associations remained significant even after adjustment for covariates[aRR 1.05,95％CI 1.01-1.09;P＜0.001].Compared with normal weight,maternal obesity before pregnancy increased the risk of CHD in offsprings(aRR 2.20,95％CI 1.40-3.46;P=0.001).Subgroup analysis showed that the maternal overweight or obesity resulted in 3.7-fold higher risk of complex CHD in overweight/obesity group than in control group(aRR 3.76,95％CI 1.62-8.69;P=0.002).Conclusion The increase in maternal BMI before pregnancy increases the risk of offspring CHD,especially the risk of complex CHD.To reduce the risk of CHD and improve the health level of offsprings,more attention should be paid to the intervention of maternal pre-pregnancy obesity in clinical practice.
maternal obesitycongenital heart diseasepre-pregnancybody mass index
国家科技期刊平台
NSTL
万方数据
