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To evaluate first trimester maternal weight as a spina bifida screening marker. Case-control study of spina bifida and unaffected pregnancies; cases were from national records and controls from women referred to prenatal screening centers in the Ukraine. The median and inter-quartile range of weight, body mass index (BMI) and the obesity rate (BMI ≥ 30 kg/m 2 ) were compared. Discriminatory power was assessed by logistic regression. Gaussian modeling was used to predict the additional spina bifida detection when weight was included as a screening marker risk in addition to first trimester biparietal diameter (BPD) and serum α-fetoprotein (AFP). There were 97 cases and 274 controls. The distribution of maternal weight was increased in cases by 3 kg, on average, about 5% ( p  &lt; .05); BMI was increased about 8% ( p  &lt; .005). Some 15% of cases were obese compared with 6.9% of controls ( p  &lt; .02). In logistic regression including BMI and maternal age, 29% cases and 9.8% controls had high risk of spina bifida. Modeling predicted that incorporating weight would increase the detection rate compared with BPD and AFP alone by 3% and BMI would increase it by 4%. Incorporating maternal weight into first trimester spina bifida screening protocols will increase detection.

Maternal weight as an additional first trimester spina bifida screening marker