• Research Review
• Journal Summary

Author: T Hampton

Reference: JAMA 2004; 292: 789-790, http://jama.ama-assn.org/cgi/content/extract/292/7/789

Summarized by: Barbara Roberts, MD, Women's Heart Health Editor, ProCor

The study conducted in Canada addresses the impact of the growing obesity and diabetes epidemics on pregnant women and their offspring.

Spina bifida and other neural tube defects are significally associated with maternal obesity, as they are with folate deficiency and poor diets. The incidence of anencephaly is also increased among offspring of obese mothers. The link between maternal obesity and neural tube defects is independent of race or ethnicity, type of diabetes (so-called juvenile or adult onset), and the presence of folic acid and other nutrients in the diet. Scientists suspect that abnormal glucose metabolism may play a role in the increase in birth defects in the offspring of obese mothers. The incidence of neural tube defects has been particularly high among fetuses of obese women who ate foods with a high glycemic index. Treatment is controversial because low weight gain or dieting during pregnancy are also associated with an increased risk for neural tube defects.

Among women with type 2 diabetes there is a higher risk of miscarriage. Babies born to women with this disease have six times the risk of death by age one and 11 times the risk of congenital malformations. There is also a risk of higher birth weight and obesity in later life. More research is needed but as with so many conditions, "it is far better to prevent maternal obesity in the first place."