Prepregnancy Weight and Pregnancy Outcome

In this issue ofTHE JOURNAL, there are two articles that describe the relationship between maternal size and a pregnancy with a neural tube defect (NTD).¹,²Both investigations are population-based, case-controlled studies involving more than 500 NTD cases and controls. Information on maternal characteristics, including pregnancy events, prepregnancy weight, and dietary intake, was obtained by in-person interviews with each mother within 5 to 6 months of delivery. The risk of NTD-affected pregnancy was estimated after adjusting for multiple confounders. These two groups of investigators independently reached a similar conclusion: women who are obese (ie, women who have a body mass index [BMI] of >29 kg/m²or body weight of more than 80 kg) at the beginning of pregnancy are more likely to have infants with NTDs and this association is independent of folate intake. Since previous studies have indicated similar relationships,³,⁴it is likely that this association