{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:55:41Z","timestamp":1792068941991,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,10,10]],"date-time":"2013-10-10T00:00:00Z","timestamp":1381363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study investigates the relationship between maternal pre\u2010pregnancy body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>) and 26 birth defects identified through the <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>lorida Birth Defects Registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pre\u2010pregnancy <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> (kg\/m<jats:sup>2<\/jats:sup>) was categorised into underweight (&lt;18.5), normal weight (18.5\u201324.9), overweight (25.0\u201329.9), and obese (\u226530.0) among Florida resident mothers without pre\u2010gestational diabetes who gave birth to singleton infants from <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>arch 2004 through <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2009. Obesity was classified as obese <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content> (30.0\u201334.9), obese <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> (35.0\u201339.9), and obese <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> (\u226540.0). Logistic regression was used to calculate the adjusted odds ratios and 95% confidence interval, representing the association between pre\u2010pregnancy <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and each of the 26 specific birth defects (and an \u2018any birth defect\u2019 composite). Models were adjusted for maternal age, race\/ethnicity, education, smoking, marital status, and nativity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The livebirth prevalence of any birth defect increased with increasing <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>, from 3.9% among underweight women to 5.3% among obese <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> women (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Results show a direct dose\u2013response relationship between maternal pre\u2010pregnancy <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and 10 defects under study (cleft palate without cleft lip, diaphragmatic hernia, hydrocephalus without spina bifida, hypoplastic left heart syndrome, pulmonary valve atresia and stenosis, pyloric stenosis, rectal and large intestinal atresia\/stenosis, transposition of great arteries, tetralogy of Fallot, and ventricular septal defects) and the \u2018any birth defect\u2019 category. Conversely, gastroschisis exhibited a statistically significant inverse relationship with pre\u2010pregnancy <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides evidence of the increasing risk of birth defect\u2010affected pregnancy with increasing pre\u2010pregnancy obesity. Reducing pre\u2010pregnancy obesity, even among obese women, may reduce the occurrence of birth defects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12084","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T02:03:51Z","timestamp":1381543431000},"page":"521-531","source":"Crossref","is-referenced-by-count":89,"title":["Maternal Pre\u2010Pregnancy Body Mass Index and Risk of Selected Birth Defects: Evidence of a Dose\u2013Response Relationship"],"prefix":"10.1111","volume":"27","author":[{"given":"Suzanne R.","family":"Block","sequence":"first","affiliation":[{"name":"Florida Birth Defects Registry Florida Department of Health Division of Disease Control and Health Protection Bureau of Epidemiology Environmental Epidemiology Surveillance and Response Section  Tallahassee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M.","family":"Watkins","sequence":"additional","affiliation":[{"name":"Florida Birth Defects Registry Florida 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Public Health University of South Florida  Tampa FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane A.","family":"Correia","sequence":"additional","affiliation":[{"name":"Florida Birth Defects Registry Florida Department of Health Division of Disease Control and Health Protection Bureau of Epidemiology Environmental Epidemiology Surveillance and Response Section  Tallahassee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell S.","family":"Kirby","sequence":"additional","affiliation":[{"name":"Birth Defects Surveillance Program Department of Community and Family Health College of Public Health University of South Florida  Tampa FL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,10]]},"reference":[{"issue":"6","key":"e_1_2_6_2_1","article-title":"Screening for obesity in reproductive\u2010aged women","volume":"8","author":"Zera C","year":"2011","journal-title":"Preventing Chronic 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