The impact of maternal obesity on completion of fetal anomaly screening

Kelly-Ann Eastwood; Ciara Daly; Alyson Hunter; David McCance; Ian Young; Valerie Holmes

doi:10.1515/jpm-2016-0048

Article

The impact of maternal obesity on completion of fetal anomaly screening

Kelly-Ann Eastwood , Ciara Daly , Alyson Hunter , David McCance , Ian Young and Valerie Holmes

Published/Copyright: February 1, 2017

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From the journal Journal of Perinatal Medicine Volume 45 Issue 9

Abstract

Objective:

To examine the impact of maternal obesity on completion of fetal anomaly screening.

Methods:

A retrospective analysis of 500 anomaly scans (19+0–21+6 weeks) was included. Women were categorised according to the World Health Organisation (WHO) body mass index (BMI) classification: normal weight (18.50–24.99 kg/m²), overweight (25.00–29.99 kg/m²), obese class I (30–34.99 kg/m²), obese class II (35.00–39.99 kg/m²) and obese class III (≥40.00 kg/m²). A fetal anomaly imaging scoring system was developed from the National Health Service (NHS) Fetal Anomaly Screening Programme standard to evaluate scans.

Results:

Image quality deteriorated as BMI increased and was significantly different across the BMI categories (P<0.001). Performance was poorest in imaging of the fetal chest and was significantly different across BMI categories (P<0.001). In obese class III, 33% of four-chamber cardiac views and 38% of outflow tract views were not obtained. In total, 119 women (23.6%) had an incomplete scan. In obese class III, 44.1% of scans were incomplete compared with 10.2% in the normal BMI category (P<0.001). Of 117 women attending for repeat scans, 78.6% were complete, 11.1% were incomplete, 6.8% were advised to re-attend and 3.4% were referred to Fetal Medicine.

Conclusion:

Maternal obesity has a significant impact on completion of fetal anomaly screening.

Keywords: Body mass index; fetal anomaly; obesity; pregnancy; screening; ultrasound

Author’s statement

Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

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Received: 2016-2-8

Accepted: 2016-12-28

Published Online: 2017-2-1

Published in Print: 2017-12-20

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Articles in the same Issue

https://doi.org/10.1515/jpm-2016-0048

Keywords for this article

Body mass index; fetal anomaly; obesity; pregnancy; screening; ultrasound