Abstract
Previous results are inconsistent regarding the association between maternal obesity and Apgar score or cord pH in humans. The aim of this study was to investigate the association between maternal pre-pregnancy and pregnancy body mass index (BMI) and infant Apgar score or cord pH. We conducted a systematic review of studies published in English before 20 August 2015 using PubMed, EMBASE, and Cochrane Library. Eleven cohort studies with a total of 2,586,265 participants finally met our inclusion criteria. Pooled results revealed the following factors associated with Apgar score <7 at 5 minutes: overweight (odds ratio [OR] 1.13; 95% confidence interval [CI], 1.08–1.20), obese (OR 1.40; 95% CI, 1.27–1.54), and very obese (OR 1.71; 95% CI, 1.55–1.89). The pooled analysis also revealed that maternal overweight or obesity increased the risk for Apgar score <7 at 1 minute. There was no association between maternal BMI and neonatal cord pH. Thus, this study suggests that maternal overweight and obesity affect baby’s condition immediately after birth in general. More studies are needed to confirm these results and detect the influence of variables across studies.
Highlights
Maternal overweight, obesity and very obesity by body mass index (BMI) categories was significantly associated with Apgar score < 7
The results of this systematic review and meta-analysis of 11 cohort studies with a total of 2,586,265 participants showed that infants whose mothers had a BMI ≥ 25 kg/m2 during pregnancy had an increased risk of low Apgar scores at 1 and 5 minutes
Previous studies have observed that maternal BMI was related to risks of infant mortality primarily in full-term births[24]
Summary
Obesity and very obesity by BMI categories was significantly associated with Apgar score < 7. Maternal underweight categories showed nonsignificant trends toward increased an Apgar score < 7. Note that obesity group compared with non-obese controls (BMI < 30) in the Minsart et al study. Of maternal factors that may affect Apgar score and cord pH will improve the understanding of the influence of maternal obesity and provide evidence for predicting serious conditions in order to plan appropriate neonatal care. Many human studies have published inconsistent results on the impact of maternal obesity on Apgar score and cord pH at birth. We hypothesized that neonates exposed to maternal obesity would have lower Apgar scores and cord pH than would normal controls
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