Survival of Infants with Spina Bifida and the Role of Maternal Prepregnancy Body Mass Index

Citation

Pace, Nelson D.; Siega-Riz, Anna Maria; Olshan, Andrew F.; Chescheir, Nancy C.; Cole, Stephen R.; Desrosiers, Tania A.; Tinker, Sarah C.; Hoyt, Adrienne T.; Canfield, Mark A.; & Carmichael, Suzan L., et al. (2019). Survival of Infants with Spina Bifida and the Role of Maternal Prepregnancy Body Mass Index. Birth Defects Research, 111(16), 1205-1216. PMCID: PMC7285624

Abstract

OBJECTIVE: To investigate first-year survival of infants born with spina bifida, and examine the association of maternal prepregnancy body mass index (BMI) with infant mortality.
METHODS: This is a retrospective cohort study of 1,533 liveborn infants with nonsyndromic spina bifida with estimated dates of delivery from 1998 to 2011 whose mothers were eligible for the National Birth Defects Prevention Study (NBDPS). NBDPS data were linked to death records to conduct survival analyses. Kaplan-Meier survival functions estimated mortality risk over the first year of life. Cox proportional hazards models estimated hazard ratios (HRs) for maternal prepregnancy BMI categorized as underweight (<18.5), normal (18.5-24.9), overweight (25-29.9), and obese (≥30).
RESULTS: Infant mortality risk among infants with spina bifida was (4.4% [3.52, 5.60%]). Infants with multiple co-occurring defects, very preterm delivery, multiple gestation, high-level spina bifida lesions, or non-Hispanic Black mothers had an elevated risk of infant mortality. Maternal prepregnancy underweight and obesity were associated with higher infant mortality (15.7% [7.20, 32.30%] and 5.82% [3.60, 9.35%], respectively). Adjusted HR estimates showed underweight and obese mothers had greater hazard of infant mortality compared to normal weight mothers (HR: 4.5 [1.08, 16.72] and 2.6 [1.36, 8.02], respectively).
CONCLUSION: The overall risk of infant mortality for infants born with spina bifida was lower than most previously reported estimates. Infants born with spina bifida to mothers who were underweight or obese prepregnancy were at higher risk of infant mortality. This study provides additional evidence of the importance of healthy maternal weight prior to pregnancy.

URL

http://dx.doi.org/10.1002/bdr2.1552

Reference Type

Journal Article

Year Published

2019

Journal Title

Birth Defects Research

Author(s)

Pace, Nelson D.
Siega-Riz, Anna Maria
Olshan, Andrew F.
Chescheir, Nancy C.
Cole, Stephen R.
Desrosiers, Tania A.
Tinker, Sarah C.
Hoyt, Adrienne T.
Canfield, Mark A.
Carmichael, Suzan L.
Meyer, Robert E., for the National Birth Defects Prevention Study

PMCID

PMC7285624

ORCiD

Olshan - 0000-0001-9115-5128