{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T23:10:07Z","timestamp":1747696207234,"version":"3.40.5"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study aimed to examine the impact of maternal obesity on fetal growth abnormalities including fetal growth restriction (FGR) and large for gestational age (LGA) fetuses.<\/jats:p><jats:p>Secondary analysis from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b). The study excluded individuals with pregestational or gestational diabetes, chronic hypertension, and other major maternal medical conditions. First-trimester ultrasound was performed to establish accurate dating criteria. Ultrasound assessments were performed at 16 to 21 and 22 to 29 weeks of gestation. Our exposure was the presence of prepregnancy obesity. Our primary outcome was rates of fetal growth abnormalities identified by ultrasound, defined as FGR (estimated fetal weight [EFW] or abdominal circumference &lt;10th percentile) or LGA (EFW &gt;90th percentile) among obese compared with nonobese women. A secondary analysis was performed after limiting ultrasound performed from 28 to 29 weeks. To estimate adjusted relative risks (aRRs) with 95% confidence intervals (95% CIs), we used generalized linear models with Poisson distribution and log link using robust error variance, adjusting for the predefined covariates.<\/jats:p><jats:p>Of 7,354 participants, 1,443 (19.6%) had prepregnancy obesity while 5,911 (80.4%) did not. Prepregnancy obesity compared with normal weight was associated with an increased risk of fetal growth abnormalities both at 16 to 21 weeks (16.0 vs. 13.2%; aRR\u2009=\u20091.23; 95% CI: 1.06\u20131.42) and 22 to 29 weeks (16.0 vs. 12.1%; aRR\u2009=\u20091.33; 95% CI: 1.14\u20131.54). Furthermore, prepregnancy obesity compared with normal weight was associated with an increased risk of LGA both at 16 to 21 weeks (12.5 vs. 10.3%; aRR\u2009=\u20091.24; 95% CI: 1.05\u20131.47) and 22 to 29 weeks (10.6 vs. 6.9%; aRR\u2009=\u20091.66; 95% CI: 1.38\u20132.01). In a secondary analysis limited to the ultrasound at 28 to 29 weeks, both fetal growth abnormalities and LGA were associated with the presence of obesity. In any of the analyses, prepregnancy obesity was not associated with FGR compared with normal weight.<\/jats:p><jats:p>Maternal obesity is associated with an increased risk of fetal growth abnormalities and LGA fetuses.<\/jats:p>","DOI":"10.1055\/a-2460-5846","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T01:12:33Z","timestamp":1730769153000},"page":"1059-1065","source":"Crossref","is-referenced-by-count":0,"title":["Fetal Growth Ultrasound in Obese Patients for the Detection of Growth Abnormalities"],"prefix":"10.1055","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1327-8979","authenticated-orcid":false,"given":"Juliana G.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2752-4061","authenticated-orcid":false,"given":"Rebecca","family":"Horgan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-1699","authenticated-orcid":false,"given":"Tetsuya","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"e128","DOI":"10.1097\/AOG.0000000000004395","article-title":"Obesity in pregnancy: ACOG Practice Bulletin, Number 230","volume":"137","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2013Obstetrics","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1001\/jama.2009.113","article-title":"Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis","volume":"301","author":"K J Stothard","year":"2009","journal-title":"JAMA"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1053\/j.semperi.2012.05.001","article-title":"Obesity and the risk and detection of fetal malformations","volume":"36","author":"D Racusin","year":"2012","journal-title":"Semin Perinatol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1002\/pd.2399","article-title":"Influence of maternal BMI on genetic sonography in the FaSTER trial","volume":"30","author":"K M Aagaard-Tillery","year":"2010","journal-title":"Prenat Diagn"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1042\/CS20190266","article-title":"Placental function in maternal obesity","volume":"134","author":"A C Kelly","year":"2020","journal-title":"Clin Sci (Lond)"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.ajog.2019.11.1243","article-title":"Chronic hypertension in pregnancy","volume":"222","author":"A N Battarbee","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"e067946","DOI":"10.1136\/bmj-2021-067946","article-title":"Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis","volume":"377","author":"W Ye","year":"2022","journal-title":"BMJ"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1097\/AOG.0000000000003606","article-title":"Macrosomia: ACOG Practice Bulletin, Number 216","volume":"135","author":"American College of Obstetricians and Gynecologists","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"e97","DOI":"10.1097\/AOG.0000000000003070","article-title":"ACOG Practice Bulletin No. 204: Fetal growth restriction","volume":"133","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2014Obstetrics and the Society forMaternal-FetalMedicin","year":"2019","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"708","DOI":"10.3109\/14767058.2010.516285","article-title":"Fundal height: a useful screening tool for fetal growth?","volume":"24","author":"T N Sparks","year":"2011","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1148\/radiology.152.2.6739822","article-title":"Estimating fetal age: computer-assisted analysis of multiple fetal growth parameters","volume":"152","author":"F P Hadlock","year":"1984","journal-title":"Radiology"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0033-8389(22)01218-0","article-title":"Sonographic estimation of fetal age and weight","volume":"28","author":"F P Hadlock","year":"1990","journal-title":"Radiol Clin North Am"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/0002-9378(85)90298-4","article-title":"Estimation of fetal weight with the use of head, body, and femur measurements\u2013a prospective study","volume":"151","author":"F P Hadlock","year":"1985","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1148\/radiology.181.1.1887021","article-title":"In utero analysis of fetal growth: a sonographic weight standard","volume":"181","author":"F P Hadlock","year":"1991","journal-title":"Radiology"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"e20190076","DOI":"10.1542\/peds.2019-0076","article-title":"A 2017 US reference for singleton birth weight percentiles using obstetric estimates of gestation","volume":"144","author":"I M Aris","year":"2019","journal-title":"Pediatrics"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach","volume":"44","author":"E R DeLong","year":"1988","journal-title":"Biometrics"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1001\/jamapediatrics.2017.3785","article-title":"Association of maternal obesity with longitudinal ultrasonographic measures of fetal growth","volume":"172","author":"C Zhang","year":"2018","journal-title":"JAMA Pediatr"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.ajog.2004.05.052","article-title":"The influence of obesity and diabetes on the prevalence of macrosomia","volume":"191","author":"H M Ehrenberg","year":"2004","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1080\/03014469800005402","article-title":"Maternal prepregnancy weight status and pregnancy weight gain as major determinants for newborn weight and size","volume":"25","author":"S Kirchengast","year":"1998","journal-title":"Ann Hum Biol"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1515\/JPM.2000.056","article-title":"Effect of maternal weight gain on infant birth weight","volume":"28","author":"C Shapiro","year":"2000","journal-title":"J Perinat Med"},{"issue":"12","key":"ref22","first-page":"1223","article-title":"Prepregnancy body mass, gestational weight gain and birth weight [in Polish]","volume":"69","author":"W M Kanadys","year":"1998","journal-title":"Ginekol Pol"},{"issue":"02","key":"ref23","first-page":"71","article-title":"Influence of prepregnancy weight and maternal weight gain on pregnancy outcome [in Chinese]","volume":"33","author":"B Sun","year":"1998","journal-title":"Zhonghua Fu Chan Ke Za Zhi"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000350170","article-title":"Impact of maternal obesity on fetal health","volume":"34","author":"K Tenenbaum-Gavish","year":"2013","journal-title":"Fetal Diagn Ther"},{"issue":"10","key":"ref25","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1080\/14767058.2020.1773427","article-title":"Severity of fetal growth restriction stratified according to maternal obesity","volume":"35","author":"L D Tanner","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.3390\/nu13041213","article-title":"Maternal obesity and risk of low birth weight, fetal growth restriction, and macrosomia: multiple analyses","volume":"13","author":"M Lewandowska","year":"2021","journal-title":"Nutrients"},{"issue":"03","key":"ref27","first-page":"292","article-title":"The implications and consequences of maternal obesity on fetal intrauterine growth restriction","volume":"6","author":"L Radulescu","year":"2013","journal-title":"J Med Life"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"e61627","DOI":"10.1371\/journal.pone.0061627","article-title":"Prepregnancy body mass index in relation to infant birth weight and offspring overweight\/obesity: a systematic review and meta-analysis","volume":"8","author":"Z Yu","year":"2013","journal-title":"PLoS One"},{"issue":"10","key":"ref29","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1111\/j.1471-0528.2006.00989.x","article-title":"The short- and long-term implications of maternal obesity on the mother and her offspring","volume":"113","author":"P M Catalano","year":"2006","journal-title":"BJOG"},{"issue":"06","key":"ref30","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1002\/uog.23646","article-title":"Influence of maternal body mass index on interobserver variability of fetal ultrasound biometry and amniotic-fluid assessment in late pregnancy","volume":"58","author":"J G Martins","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s00404-022-06495-3","article-title":"Impact of maternal body mass index on the accuracy of third trimester sonographic estimation of fetal weight","volume":"307","author":"J Gevaerd Martins","year":"2023","journal-title":"Arch Gynecol Obstet"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2460-5846.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T22:36:34Z","timestamp":1747694194000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2460-5846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,4]]},"references-count":30,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2025,5,19]]},"published-print":{"date-parts":[[2025,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2460-5846","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2024,11,4]]},"published":{"date-parts":[[2024,11,4]]}}}