Postpartum Weight: A Guide for Calculation of the Expected Prepregnancy Weight to Study the Risk of Maternal Overweight and Obesity on Congenital Anomalies

Objectives: To study the risk of maternal overweight and obesity on congenital anomalies (CAs) using the expected prepregnancy body mass index (EPPBMI) calculated from the postpartum weight. Methods: By deciding four difference factors, one for low, normal, overweight, and obese mothers as 60% of the pregnancy weight gain, then subtracting each factor from the corresponding postpartum weight to calculate the EPPBMI, to study the risk of overweight and obesity on CAs, applied retrospectively on mothers examined in the birth defect center of Al-Ramadi city, Iraq. For every mother delivered CA-affected baby, two mothers delivered healthy neonates were selected randomly as controls. Calculated EPPBMI of the cases compared with controls to study the risk of maternal obesity on CAs using the Odd's ratio and 95% confidence interval as a measure of the risk significance. Results: Enrolled mothers were 184 delivered 184 CA-affected neonates, 115 male and 69 female. Mother's age was 16-44 years (mean 28.3 years), their postpartum weight was 52-108 kg (mean 74.6 kg). Both postpartum BMI and EPPBMI in cases showed higher overweight and obesity than in controls. Obesity and overweight found risk factors for studied CAs. Obesity found a risk factor for development of VSD, ASD, congenital hip dislocation, hydrocephalus, meningomyelocele, lip & palate defects, and down's syndrome, while overweight found a risk factor for ASD. Conclusion: EPPBMI calculation from the postpartum weight is easy and will make the study of the risk of maternal obesity on CAs simple, especially in areas with poor antenatal care. Overweight and obesity found risk factors for certain CAs. Social education about the early antenatal care and control of obesity before pregnancy are important to reduce the prevalence of CAs.