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The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis

Authors

  • N. Heslehurst,

    Corresponding author
    1. The Centre for Food, Physical Activity, and Obesity Research, School of Health and Social Care, University of Teesside, Middlesbrough, UK;
      N Heslehurst, The Centre for Food, Physical Activity, and Obesity Research, School of Health and Social Care, University of Teesside, Middlesbrough, Teesside TS1 3BA, UK. E-mail: n.heslehurst@tees.ac.uk
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  • H. Simpson,

    1. Directorate of Women and Children, James Cook University Hospital, Middlesbrough, UK;
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  • L. J. Ells,

    1. The North East Public Health Observatory, Wolfson Research Institute, Durham University, Stockton on Tees, UK;
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  • J. Rankin,

    1. Institute of Health and Society, Newcastle University, Newcastle, UK;
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  • J. Wilkinson,

    1. The North East Public Health Observatory, Wolfson Research Institute, Durham University, Stockton on Tees, UK;
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  • R. Lang,

    1. The Centre for Food, Physical Activity, and Obesity Research, School of Health and Social Care, University of Teesside, Middlesbrough, UK;
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  • T. J. Brown,

    1. The Centre for Food, Physical Activity, and Obesity Research, School of Health and Social Care, University of Teesside, Middlesbrough, UK;
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  • C. D. Summerbell

    1. School for Medicine and Health, Wolfson Research Institute, Durham University, Stockton on Tees, UK
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N Heslehurst, The Centre for Food, Physical Activity, and Obesity Research, School of Health and Social Care, University of Teesside, Middlesbrough, Teesside TS1 3BA, UK. E-mail: n.heslehurst@tees.ac.uk

Summary

Obesity is rising in the obstetric population, yet there is an absence of services and guidance for the management of maternal obesity. This systematic review aimed to investigate relationships between obesity and impact on obstetric care. Literature was systematically searched for cohort studies of pregnant women with anthropometric measurements recorded within 16-weeks gestation, followed up for the term of the pregnancy, with at least one obese and one comparison group. Two researchers independently data-extracted and quality-assessed each included study. Outcome measures were those that directly or indirectly impacted on maternity resources. Primary outcomes included instrumental delivery, caesarean delivery, duration of hospital stay, neonatal intensive care, neonatal trauma, haemorrhage, infection and 3rd/4th degree tears. Meta-analysis shows a significant relationship between obesity and increased odds of caesarean and instrumental deliveries, haemorrhage, infection, longer duration of hospital stay and increased neonatal intensive care requirement. Maternal obesity significantly contributes to a poorer prognosis for mother and baby during delivery and in the immediate post-partum period. National clinical guidelines for management of obese pregnant women, and public health interventions to help safeguard the health of mothers and their babies are urgently required.

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