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Association between maternal adiposity measures and adverse maternal outcomes of pregnancy: systematic review and meta-analysis

Lookup NU author(s): Dr Nicola HeslehurstORCiD, Lem Ngongalah, Dr Theophile Bigirumurame, Dr Gina NguyenORCiD, Dr Lisa Crowe, Dr Louise HayesORCiD



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


Maternal obesity increases pregnancy-related risks. Women with a BMI≥30kg/m2 are considered to be at risk and should receive additional care, although approximately half will have uncomplicated pregnancies. This systematic review aimed to identify early pregnancy measures of adiposity associated with adverse maternal health outcomes. Searches included six databases, reference lists, citations and contacting authors. Screening and quality assessment were carried out by two authors independently. Random effects meta-analysis and narrative synthesis were conducted. Seventy studies were included with a pooled sample of 89,588 women. Meta-analysis showed significantly increased odds of gestational diabetes (GDM) with higher waist circumference (WC) categories (1.40, 95%CI 1.04-1.88) and per unit increase in WC (1.31, 95%CI 1.03-1.67). Women with GDM had higher WC than controls (MD 6.18cm, 95%CI 3.92-8.44). WC was significantly associated with hypertensive disorders, delivery-related outcomes, metabolic syndrome and composite pregnancy outcomes. Waist to hip ratio was significantly associated with GDM, hypertensive disorders and delivery-related outcomes. Fat mass, neck circumference, skinfolds and visceral fat were significantly associated with adverse outcomes, although limited data were available. Our findings identify the need to explore how useful adiposity measures are at predicting risk in pregnancy, compared with BMI, to direct care to women with the greatest need.Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK

Publication metadata

Author(s): Heslehurst N, Ngongalah L, Bigirumurame T, Nguyen TG, Odeniyi A, Flynn A, Smith V, Crowe L, Skidmore B, Gaudet L, Simon A, Hayes L

Publication type: Article

Publication status: Published

Journal: Obesity Reviews

Year: 2022

Volume: 23

Issue: 7

Print publication date: 01/07/2022

Online publication date: 25/04/2022

Acceptance date: 15/03/2022

Date deposited: 27/04/2022

ISSN (print): 1467-7881

ISSN (electronic): 1467-789X

Publisher: Wiley-Blackwell Publishing Ltd


DOI: 10.1111/obr.13449


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