Mothers who are obese are more likely to give birth to a baby with birth defects, according to an analysis published in the Journal of the American Medical Association.

Spina bifida is twice as likely to occur in babies whose mothers are obese as opposed to those born to mothers of a healthy weight. The odds of babies experiencing heart defects and cleft palate, among other birth defects, are also higher in obese mothers, the researchers found.

Obese is defined as having a body mass index (BMI) greater than 30.

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“This has health implications, particularly given the continued rise in the prevalence of obesity in many countries,” the authors write.