Maternal Obesity and Neural Tube Defects - A Malaysian Perspective (Interim Analysis)

Aim: To determine the incidence of maternal obesity and maternal characteristics of Malaysian women with neural tube defects (NTD)-affected pregnancy.

Methods: This was a single-center retrospective analysis involving women with NTD-affected pregnancy in Sultanah Aminah Hospital from the Johor Bharu region of Malaysia in year 2015. Subjects’ body mass index (BMI; kg/m2) during their first antenatal visit was obtained and categorized into six groups: underweight (<18.50), normal weight (18.50-24.99), overweight (25-29.99), obesity Class I (30-34.99), obesity Class II (35-39.99) or obesity Class III(≥40). Data on maternal characteristics including age, ethnicity, gravidity, period of amenorrhea (POA) at booking and diabetic status was also collected.

Results: There were a total of 17 subjects with NTD-related pregnancy, providing an incidence of 1.2 per 1000 deliveries. The most common NTD diagnosis was anencephaly (n=9;52.9%). Mean age of the subjects was 30±4.7 years. The majority of subjects were Malay ethnicity (58.5%), multigravida (70.6%), has a booking of less than 20 weeks of POA (82.4%) and non-diabetics (52.9%). Mean and standard deviation of the subject’s BMI was 25.45±5.07 kg/m2. The distribution of under-to-normal weight (BMI < 25), overweight and obese classification were 53%, 29.4% and 17.6% respectively.

Conclusion: The incidence of maternal obesity in women with NTD-affected pregnancy was 17.6% from the study population. Almost half of the subjects were under- and normal weight.

As this is an interim analysis, a bigger sample is required to provide a deeper understanding on the effect of maternal obesity and NTDs.