The association of maternal BMI with fetal echogenic intracardiac foci and echogenic bowel

Objectives. To evaluate the impact of maternal body mass index (BMI) as well as maternal ethnicity on the detection of either echogenic intra-cardiac focus (EIF) or echogenic bowel (EB). Methods. This prospective study identified 74 uncomplicated singleton fetuses in which EIF and/or EB were detected between 18 and 21 weeks of gestation (i.e. study group). Seventy four consecutively scanned fetuses without EIF or EB, at the same gestational age, were selected as controls. The differences in maternal BMI and maternal ethnicity were compared between the two groups using the χ² test, Fisher's exact test, and the Student t-test. A multivariable logistic regression model was constructed to control for confounders. Odds ratios (OR) and their 95% confidence interval (CI) were computed. Results. The mean maternal BMI was significantly lower in the study group as compared to controls (22.9±3.1 vs. 28.0±7.5kg/m², respectively; p<0.0001). Patients with fetal EIF and/or EB were significantly more likely to be Asians (20.3 vs. 5.4, OR=4.5; 95 CI 1.3-16.9). Using a multivariable analysis, controlling for ethnicity, the association between maternal BMI and fetal EIF or EB remained significant (OR=0.83; 95 CI 0.7-60.91). However, based on this model Asian ethnicity was not an independent risk factor for the detection of EIF and/or EB (OR=2.6; 95 CI 0.8-8.9). Conclusions. Our data suggests an inverse relationship between the maternal BMI and the detection of fetal EIF and/or EB. Moreover, it appears that low maternal BMI, and not Asian ethnicity, is an independent risk factor for the detection of these echogenic fetal findings.