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Prenat Diagn. 2010 Jan;30(1):14-22. doi: 10.1002/pd.2399.

Influence of maternal BMI on genetic sonography in the FaSTER trial.

Author information

1
University of Utah, Salt Lake City, UT, USA. aagaardt@bcm.tmc.edu

Abstract

OBJECTIVE:

We sought to evaluate the influence of maternal body mass index (BMI) on sonographic detection employing data from the FaSTER trial.

METHOD:

Unselected singleton pregnancies underwent detailed genetic sonogram to evaluate for structural fetal anomalies and soft markers for aneuploidy. BMI (kg/m(2)) were calculated from reported initial visit values. Sensitivity, specificity, false positive and false negative rates (FPR and FNR), likelihood ratio, detection rates, and a missed diagnosis rate (MDR: FNR + marker recorded as 'missing'/N) were calculated.

RESULTS:

Eight thousand five hundred and fifty-five patients with complete BMI information had detailed genetic sonography. A lower sensitivity with an elevated FNR and MDR was observed in obese women for multiple aneuploid markers (e.g. > or =2 markers 32% sensitivity with 68% FNR among BMI <25 vs 22% and 78% among BMI >30). Similarly, the detection rate for cardiac anomalies among women at BMI <25 was higher (21.6%) at a significantly lower FPR (78.4%; 95% CI 77.3-79.5%) in comparison to obese women (8.3% with FPR 91.7%; 95% CI 90.1-93.2%). In a logistic regression model, maternal obesity significantly decreased the likelihood of sonographic detection of common anomalies (adjusted OR 0.7; 95% CI 0.6-0.9; p = 0.001).

CONCLUSION:

The performance of second trimester genetic sonography is influenced by obesity, with a significantly higher MDR for multiple minor markers and lower likelihood for detecting common anomalies.

PMID:
19918963
DOI:
10.1002/pd.2399
[Indexed for MEDLINE]

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