Association between maternal overweight or obesity and cerebral palsy in children: A meta-analysis.

Dongqiong Xiao,Lan Huang,Yi Qu,Yan Wang,Gemma C. Sharp,Dezhi Mu,Xihong Li

doi:10.1371/journal.pone.0205733

Dongqiong Xiao, Lan Huang + Show 5 more

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https://doi.org/10.1371/journal.pone.0205733

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Abstract

ContextThere is no consensus regarding the association between maternal obesity or overweight and cerebral palsy (CP) in children.ObjectivesTo investigate whether maternal obesity or overweight is associated with CP and identify the factors that explain the differences in the study results.Data sourcesWe conducted a meta-analysis of studies published in English with titles or abstracts that discussed the relationships between maternal obesity or overweight and CP before August 23, 2017, using Ovid Medline, EMBASE and Web of Science.Study selectionOf 2699 initially identified studies, 8 studies that addressed the association between maternal obesity and CP met our final inclusion criteria.Data extractionInformation from the individual studies was abstracted using standardized forms by 2 independent observers who were blinded to the authors’ names and journal titles.Data synthesisAccording to a random effects model, maternal overweight was significantly associated with CP in offspring [RR = 1.29 (95% CI, 1.04–1.60), heterogeneity (I2 = 45.5%, P = 0.103)]; maternal obesity was significantly associated with CP in offspring [RR = 1.45 (95% CI, 1.25–1.69), heterogeneity (I2 = 24.1%, P = 0.253)]; and maternal obesity III was significantly associated with CP in offspring [RR = 2.25 (95% CI, 1.82–2.79), heterogeneity (I2 = 0%, P = 0.589)]. However, maternal underweight was not significantly associated with CP in offspring [RR = 1.11 (95% CI, 0.88–1.38), low heterogeneity (I2 = 0%, P = 0.435)]. Factors that explained the differences in the meta-analysis results included study design, study location, and whether individual studies adjusted for potential confounders.ConclusionThis study suggests that maternal obesity and overweight increase the risk of CP in offspring. Further studies are required to confirm these results and determine the influence of variables across studies.

Highlights

Obesity is becoming an epidemic health problem
To investigate whether maternal obesity or overweight is associated with cerebral palsy (CP) and identify the factors that explain the differences in the study results
This study suggests that maternal obesity and overweight increase the risk of CP in offspring

Summary

Introduction

Obesity is becoming an epidemic health problem. This trend is true for maternal obesity and overweight, which may be associated with adverse obstetric complications[1, 2]. Maternal obesity is associated with low Apgar scores at 5 minutes[2, 3], preterm birth[4], low birth weight, periventricular leukomalacia (PVL)[5], autism spectrum disorders (ASDs)[6, 7], and intellectual disability[8], which could alter the offspring’s neurodevelopmental outcomes[6]. Maternal obesity is associated with an increased risk of gestational diabetes, hypertension, and preeclampsia, which may be associated with adverse neurodevelopmental outcomes[9]. Maternal obesity is associated with type 2 diabetes, congenital anomalies[10], and asthma [11] in offspring. Maternal obesity and overweight are the leading cause of public health problems. More than half of women receiving prenatal care in the United States are overweight or obese [12], and maternal obesity and overweight are epidemic in Sweden[13] and other countries

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