This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Martha M. Werler, ScD; Carol Louik, ScD; Samuel Shapiro, MD, FRCPE; Allen A. Mitchell, MD

JAMA. 1996;275(14):1089-1092.

Abstract
Objective.
—To examine the relation between prepregnant weight and the risk of neural tube defects (NTDs).

Design.
—Data were collected from 1988 to 1994 in a case-control surveillance program of birth defects.

Setting.
—Study subjects were ascertained at tertiary care centers and birth hospitals in the greater metropolitan areas of Boston, Mass, and Philadelphia, Pa, and in southeastern Ontario.

Participants.
—Cases were 604 fetuses or infants with an NTD identified within 6 months of delivery. Controls were 1658 fetuses or infants with other major malformations identified within 6 months of delivery. For 1992 to 1994, there were 93 control infants without major malformations.

Main Outcome Measure.
—Relative risk of NTDs in infants or fetuses for different maternal weights.

Results.
—Relative to women who weighed 50 to 59 kg, risk of NTDs increased from 1.9 (95% confidence interval [CI], 1.2 to 2.9) for women weighing 80 to 89 kg to 4.0 (95% CI, 1.6 to 9.9) for women weighing 110 kg or more. When women were classified according to daily intake above or below the recommended level of 400 µg of folate, approximate threefold increases in risk were estimated for the heaviest weights in both groups. Intakes of 400 µg of folate or more reduced risk of NTDs by 40% among women weighing less than 70 kg, but no risk reduction was observed among heavier women.

Conclusion.
—The risk of NTDs increased with increasing prepregnant weight, independent of the effects of folate intake.

(JAMA. 1996;275:1089-1092)

Author Affiliations
From the Slone Epidemiology Unit, Boston University School of Public Health, Brookline, Mass.

Footnotes
Presented in part at the 35th Annual Meeting of the Teratology Society, Newport Beach, Calif, June 28, 1995.

Reprints: Martha M. Werler, ScD, Slone Epidemiology Unit, Boston University School of Public Health, 1371 Beacon St, Brookline, MA 02146.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Maternal Vitamin B12 Status and Risk of Neural Tube Defects in a Population With High Neural Tube Defect Prevalence and No Folic Acid Fortification
Molloy et al.
Pediatrics 2009;123:917-923.
ABSTRACT | FULL TEXT  

Maternal Overweight and Obesity and the Risk of Congenital Anomalies: A Systematic Review and Meta-analysis
Stothard et al.
JAMA 2009;301:636-650.
ABSTRACT | FULL TEXT  

Insulin sensitizing drugs for weight loss in women of reproductive age who are overweight or obese: systematic review and meta-analysis
Nieuwenhuis-Ruifrok et al.
Hum Reprod Update 2009;15:57-68.
ABSTRACT | FULL TEXT  

Type 2 diabetes in pregnancy: importance of optimized care before, during and after pregnancy
Keely
Obstet Med 2008;1:72-77.
ABSTRACT | FULL TEXT  

The methylenetetrahydrofolate reductase C677T genotype and the risk of obesity in three large population-based cohorts.
Lewis et al.
Eur J Endocrinol 2008;159:35-40.
ABSTRACT | FULL TEXT  

Prepregnancy Obesity as a Risk Factor for Structural Birth Defects
Waller et al.
Arch Pediatr Adolesc Med 2007;161:745-750.
ABSTRACT | FULL TEXT  

Periconceptional Multivitamin Use Reduces the Risk of Preeclampsia
Bodnar et al.
Am J Epidemiol 2006;164:470-477.
ABSTRACT | FULL TEXT  

Advances in Understanding the Molecular Causes of Diabetes-Induced Birth Defects
Loeken
Reproductive Sciences 2006;13:2-10.
ABSTRACT  

Maternal ethnicity and risk of neural tube defects: a population-based study
Ray et al.
CMAJ 2004;171:343-345.
ABSTRACT | FULL TEXT  

Periconceptional Dietary Intake of Choline and Betaine and Neural Tube Defects in Offspring
Shaw et al.
Am J Epidemiol 2004;160:102-109.
ABSTRACT | FULL TEXT  

Neural tube defects associated with maternal periconceptional dietary intake of simple sugars and glycemic index
Shaw et al.
Am. J. Clin. Nutr. 2003;78:972-978.
ABSTRACT | FULL TEXT  

Management issues for women with epilepsy: Neural tube defects and folic acid supplementation
Yerby
Neurology 2003;61:S23-26.
ABSTRACT | FULL TEXT  

Maternal Obesity and Risk for Birth Defects
Watkins et al.
Pediatrics 2003;111:1152-1158.
ABSTRACT | FULL TEXT  

Causal Knowledge as a Prerequisite for Confounding Evaluation: An Application to Birth Defects Epidemiology
Hernan et al.
Am J Epidemiol 2002;155:176-184.
ABSTRACT | FULL TEXT  

Use of Atypical Antipsychotics During Pregnancy and the Risk of Neural Tube Defects in Infants
Koren et al.
Am. J. Psychiatry 2002;159:136-137.
ABSTRACT | FULL TEXT  

Lowered weight gain during pregnancy and risk of neural tube defects among offspring
Shaw et al.
Int J Epidemiol 2001;30:60-65.
ABSTRACT | FULL TEXT  

Obesity and pregnancy: complications and cost
Galtier-Dereure et al.
Am. J. Clin. Nutr. 2000;71:1242S-1248.
ABSTRACT | FULL TEXT  

Overweight, Obesity, and Health Risk
National Task Force on the Prevention and Treatmen
Arch Intern Med 2000;160:898-904.
ABSTRACT | FULL TEXT  

Neural-Tube Defects
Botto et al.
NEJM 1999;341:1509-1519.
FULL TEXT  

Summary of a Scientific Conference on Preventive Nutrition: Pediatrics to Geriatrics
Deckelbaum et al.
Circulation 1999;100:450-456.
FULL TEXT  

Predictors of Red Cell Folate Level in Women Attempting Pregnancy
Brown et al.
JAMA 1997;277:548-552.
ABSTRACT  

MATERNAL OBESITY: A RISK FACTOR FOR NEURAL TUBE DEFECTS?
JWatch General 1996;1996:2-2.
FULL TEXT  

Prepregnancy Weight and Pregnancy Outcome
Goldenberg and Tamura
JAMA 1996;275:1127-1128.
ABSTRACT