Abstract
BackgroundMaternal body mass index is linked to short- and long-term unfavorable health outcomes both for child and mother. We conducted a systematic review and meta-analysis of population-based cohort studies to evaluate maternal BMI and the risk of harmful neonatal outcomes in China.MethodsSix databases identified 2454 articles; 46 met the inclusion criteria for this study. The dichotomous data on maternal BMI and harmful neonatal outcomes were extracted. Pooled statistics (odds ratios, ORs) were derived from Stata/SE, ver. 12.0. Sensitivity analyses assessed the robustness of the results. Meta-regression and subgroup meta-analyses explored heterogeneity.ResultsThe meta-analysis revealed that compared with normal BMI, high maternal BMI is associated with fetal overgrowth, defined as macrosomia ≥4000 g (OR 1.91, 95% CI 1.75–2.09); birth weight ≥ 90% for gestational age (OR 1.88, 95% CI 1.64–2.15); and increased risk of premature birth (OR 1.38, 95% CI 1.25–2.52) and neonatal asphyxia (OR 1.74, 95% CI 1.39–2.17). Maternal underweight increased the risk of low birth weight (OR 1.61, 95% CI 1.33–1.93) and small for gestational age (OR 1.75, 95% CI 1.51–2.02).ConclusionsRaised as well as low pre-pregnancy BMI is associated with adverse neonatal outcomes. Management of weight during pregnancy might help reduce their adverse neonatal outcomes in future intervention studies or programmes.
Highlights
Maternal body mass index is linked to short- and long-term unfavorable health outcomes both for child and mother
Regarding the category of pre-pregnancy Body mass index (BMI), 6 studies were based on the World Health Organization (WHO) standard [18,19,20,21,22,23], 3 were based on Asia-Pacific standard (APS) recommendations [24,25,26], and 30 studies were based on the Working Group on Obesity in China (WGOC) standard [6, 27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55]
In terms of birth weight categories, low birth weight (LBW) was investigated in 15 studies [6, 21, 24,25,26,27, 33, 37, 39,40,41, 46, 49, 52, 55], small for gestational age (SGA) in 10 studies [6, 18, 20, 28, 32, 41, 43, 45, 50, 52], macrosomia in 27 studies [6, 18, 21,22,23,24,25,26, 33, 34, 36,37,38,39,40,41,42, 44, 46,47,48,49,50,51, 53,54,55], and Large for gestational age (LGA) in 7 studies [6, 20, 28, 41, 43, 45, 53]
Summary
Maternal body mass index is linked to short- and long-term unfavorable health outcomes both for child and mother. We conducted a systematic review and meta-analysis of population-based cohort studies to evaluate maternal BMI and the risk of harmful neonatal outcomes in China. Among adults of all ages, women generally have higher rates of obesity than men [2]. Rates of obesity in pregnancy are increasing, in developed countries [3, 4]. In the USA, a survey indicated that 55.8% of women of childbearing age (20–39 years) were overweight or obese, defined as having a BMI of 25 or higher [5]. It is worth emphasizing that China is the country with the highest rate of childhood obesity [2]. Overweight and obesity is an increasing health burden in China. The rate of maternal overweight and obesity is 25.1% as reported in the Chinese population [6].
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