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Predictors of Adverse Pregnancy Outcomes in Pregnant Women Living with Obesity: A Systematic Review

Lookup NU author(s): Dr Nicola HeslehurstORCiD, Dr Louise HayesORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2022 by the authors. Licensee MDPI, Basel, Switzerland.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.

Publication metadata

Author(s): Fakhraei R, Denize K, Simon A, Sharif A, Zhu-Pawlowsky J, Dingwall-Harvey ALJ, Hutton B, Pratt M, Skidmore B, Ahmadzai N, Heslehurst N, Hayes L, Flynn AC, Velez MP, Smith G, Lanes A, Rybak N, Walker M, Gaudet L

Publication type: Review

Publication status: Published

Journal: International Journal of Environmental Research and Public Health

Year: 2022

Volume: 19

Issue: 4

Print publication date: 01/02/2022

Online publication date: 12/02/2022

Acceptance date: 03/02/2022

ISSN (print): 1661-7827

ISSN (electronic): 1660-4601

Publisher: MDPI


DOI: 10.3390/ijerph19042063

Notes: This article belongs to the Special Issue Advances in Obesity Prevention and Weight Management during Pregnancy