The Relationship Between Maternal Prepregnancy Body Mass Index And Fetal Congenital Heart Defects In Fujian

ObjectiveFetal congenital heart diseases (CHD), as the most frequent disease of congenitalanomalies in China, is one of the leading causes of infant deaths and disability. Theetiology of CHD is extremely complex. This study explores the relationship betweenmaternal prepregnancy body mass index(BMI) and the fetal CHD to provide scientificbasis for primary prevention of CHD and the formulation of public healthintervention.MethodThere were186cases and286controls pregnant women during January,2010toJanuary,2014who came from Fujian Provincial Maternity and Child Care Centerparticipated in the survey, we adopted a hospital-based1:1~2matched case-controlstudy. These pregnant women were matched according to the age and gestational age.A unification questionnaire was used, their height was measured by the maternity caredivision’s height and weight measuring instrument, prepregnancy weight was reportedby the pregnant women themselves. According to pregnancy BMI of pregnant women,participants were divided into four groups: low weight group (BMI <18.5), lownormal weight group (BMI=18.5~21.0), high normal weight group (BMI=21.1~23.9), overweight group (BMI≥24), We performed data analysis, using SPSS19.0: Ttest, Chi-squared test, univariate and multivariate logistic regression analysis wereadopted in this study based on subgroups devided by the complexity of CHD and thecondition of extracardiac anomalies.Result1. For women whose prepregnancy BMI<18.5kg/m2, the offsprings were morelikely to have CHD(OR=2.062,95%CI:1.216-3.499), especially for mergedextracardiac anomalies CHD(OR=6.000,95%CI:1.987-18.199). For women whose prepregnancy BMI were18.5~21.0kg/m2, the futus were more likely tohave merged extracardiac anomalies CHD (OR=4.186,95%CI:1.140-12.469).2. As the CHD group being devided by the clinical anatomy of CHD, no clearrelevance was found between the type of CHD and maternal prepregnancy BMI.3. The multiple factors logistic models showed: the women whose prepregnancy weight was too low(BMI<18.5kg/m2), the futus were more likely to have CHD(OR=2.190，95%CI:1.209-3.965）; eating patterns in the first trimester of pregnancy, only eat meat dishes or eat meat more than vegetables could raise the risk of CHD，the risk is(OR=5.002,95%CI:1.345-18.604)vs(OR=2.376,95%CI:1.007-5.605). Taking multivitamin(OR=0.528，95%CI：0.342-0.815)and chocolates （OR=0.475,95%CI:0.313-0.722）are protective factors of CHD. Frequent milk drinking and taking chocolates are protective factors,(OR=0.388，95%CI：0.192-0.786)vs(OR=0.438,95%CI:0.288-0.666). Pregnant women living in the countryside, the fetus will have an increased risk of CHD(OR=3.336，95%CI；1.312-8.480). The higher the degree of maternal educational level, the smaller risk for the offspring CHD, highschool level(OR=0.198,95%CI:0.045-0.863), college level and above(OR=0.160,95%CI:0.038-0.681).Conclusion1. The women whose prepregnancy weight was too low(BMI<18.5kg/m2), the futuswere more likely to CHD.2. Taking multivitamin in the first trimester of pregnancy and taking chocolates areCHD’s protective factors. Only eat meat dishes or only eat meat more thanvegetables could raise the risk of CHD.3. Pregnant women living in the countryside, the fetus will have an increased risk ofCHD, and the higher the degree of maternal educational level, the smaller risk forthe offspring CHD.