Abstract
Obesity is a well-recognized risk factor for pregnancy complications. Most studies to date are in large cohorts, with results presented in a way that assumes all women living with obesity are at equal risk. This study investigates which women living with obesity are at higher risk of specific pregnancy complications. A systematic search of MEDLINE and Embase identified 7894 prospective or retrospective cohort studies exploring predictors of adverse outcomes among pregnant women living with obesity. Following screening, 61 studies were deemed eligible. Studies were selected if the effects of exposure to any predictor amongst pregnant women living with obesity could be collected. Maternal characteristics assessed for association with adverse outcomes included maternal age, race/ethnicity, maternal height, mode of conception, complement activation factors, and history of various comorbidities/procedures. Gestational diabetes mellitus was the most studied outcome (n = 32), followed by preterm birth (n = 29), preeclampsia (n = 27), low birthweight infants (n = 20), small for gestational age newborns (n = 12), and stillbirth (n = 7). This review identified important characteristics that should be considered during the screening and follow-up sessions of pregnant women living with obesity, including pre-existing type 1 diabetes, maternal age < 20 years or ≥35 years, non-White ethnicity, abdominal adiposity obesity, and history of bariatric surgery.
Highlights
Introduction conditions of the Creative CommonsWomen living with obesity who become pregnant represent a population at risk of adverse outcomes for pregnancy and overall health issues, including diabetes and metabolic syndrome later in life [1,2]
This systematic review has identified specific predictors of adverse maternal and newborn outcomes among women with obesity. Predictors such as prepregnancy type 1 diabetes non-White ethnicity, specific groups of maternal age (
Large-forgestational-age newborns were clearly demonstrated to be more common in pregnancies of women who live with obesity and result in increased risks of caesarean section, birth injury, and admission to the neonatal intensive care unit
Summary
Women living with obesity who become pregnant represent a population at risk of adverse outcomes for pregnancy and overall health issues, including diabetes and metabolic syndrome later in life [1,2].
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