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CME Credit Offered
CME Credit Offered
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Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
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AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 1

Category: Health Equity/Community Health

Poster Session 1

(322) Bridging the social and clinical divide in congenital major birth defect etiology

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Patience T. Timi, MD (she/her/hers)

    Resident Physician
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

    • Coauthor(s)

  • Shelby A. Crants, MD (she/her/hers)

    Obstetrics and Gynecology Resident
    Department of Obstetrics and Gynecology, MassGeneral Brigham; Harvard Medical School
    Boston, Massachusetts, United States

  • AP

    Aleksandra Polic, MD

    UPMC Magee-Womens Hospital
    Pittsburgh, Pennsylvania, United States

  • LN

    Lynsa Nguyen, MD

    Valley Children's Specialty Medical Group
    Madera, California, United States

  • Etoi Garrison, MD

    Associate Professor
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

  • Amelie Pham, MD

    Maternal Fetal Medicine Specialist
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

Objective:
Poor periconception glycemic control in pre-existing diabetes is known to be associated with major congenital birth defects. The independent association between maternal social health drivers (SHD) and the risk of birth defects remains unclear.

Study Design:
We evaluated all deliveries at a single academic center between 2010–2020 with periconception A1C value < 6.5%. Major birth defects were identified via manual chart review of both maternal and infant charts using strict CDC and EUROCAT definitions. Deliveries affected by known aneuploidy or genetic syndromes were excluded. Poisson regression was used to assess the relationship between individual maternal SHD and any birth defects. Models were adjusted using a-priori selected confounders including maternal age, pre-pregnancy body mass index (BMI) and pre-existing diabetes diagnosis.

Results:
A total of 6436 pregnancies were identified with A1c value < 6.5%. Clinical characteristics of the cohort are presented in Table 1. Crude estimates found that only social vulnerability index (SVI) subtheme 2 and BMI were associated with higher risk of birth defects (Table 2). Adjusted analyses only found a significant association between BMI and risk of any birth defects (adjusted estimate: 0.02, 95% CI: 0.01; 0.03, Table 2). In our cohort, BMI was highly associated with pre-existing diabetes diagnosis (adjusted estimate: 0.02, 95% CI: 0.01; 0.03). SVI did have a positive association with BMI (adjusted estimate: 0.14, 95% CI: 0.11; 0.16).

Conclusion:

No single maternal SHD accounted for the risk of any major birth defects in our cohort. Pre-pregnancy BMI continues to be a strong risk factor for both pre-existing diabetes and major congenital birth defects, regardless of periconception A1C, underscoring the importance of diabetes and obesity prevention and management for pregnancy. Future research should further elucidate how maternal SHDs like SVI may indirectly impact these relationships.