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Archives of Gynecology and Obstetrics

Erschienen in:

28.10.2017 | General Gynecology

Maternal pre-pregnancy obesity and the risk of macrosomia: a meta-analysis

verfasst von: Rui-xue Dai, Xiu-Jie He, Chuan-Lai Hu

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 1/2018

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Abstract

Purpose

The aim of our meta-analysis was to explore whether pre-pregnancy obesity is regarded as an important risk factor for predicting macrosomia or not.

Methods

Three databases were systematically reviewed and reference lists of relevant articles were checked. Meta-analysis of published cohort studies comparing whether pre-pregnancy obesity was associated with macrosomia and adjusting for potential confounding factors. Calculations of pooled estimates were conducted in random-effect model. Heterogeneity was tested by using Chi-square test and I ² statistics. Publication bias was estimated from Egger’s test (linear regression method) and Begg’s test (rank correlation method).

Results

Sixteen cohort studies met the inclusion criteria. The meta-analysis showed that pre-pregnancy obesity was associated with macrosomia as an important risk factor. The adjusted odds ratio was 1.93, 95% CI (1.65, 2.27) in random-effect model, stratified analyses showed no differences regarding different quality grade, definition of macrosomia, location of study and number of confounding factors adjusted for. There was no indication of a publication bias either from the result of Egger’s test or Begg’s test.

Conclusion

Our findings indicated that pre-pregnancy obesity should be considered as an important risk factor for macrosomia. The effect of pre-pregnancy obesity on macrosomia need to be carefully assessed and monitored.

Kim SY, Dietz PM, England L, Morrow B, Callaghan WM (2007) Trends in pre-pregnancy obesity in nine states, 1993–2003. Obesity 15:986–993CrossRefPubMed

Ma GS, Li YP, Wu YF, Zhai FY, Cui ZH, Hu XQ et al (2005) The prevalence of body overweight and obesity and its changes among Chinese people during 1992–2002. Chin J Prev Med 39:311–315

Maddah M, Karandish M, Mohammadpour-Ahranjani B, Neyestani TR, Vafa R, Rashidi A (2005) Social factors and pregnancy weight gain in relation to infant birth weight: a study in public health centers in Rasht, Iran. Eur J Clin Nutr 59:1208–1212CrossRefPubMed

Lepercq J, Timsit J, Hauguel-de Mouzon S (2000) Etiopathogeny of fetal macrosomia. J Gynecol Obstet Biol Reprod 29:6–12

Ogonowski J, Miazgowski T, Czeszynska MB, Jaskot B, Kuczynska M, Celewicz Z (2008) Factors influencing risk of macrosomia in women with gestational diabetes mellitus undergoing intensive diabetic care. Diabetes Res Clin Pract 80:405–410CrossRefPubMed

Wells G, Shea B, O’connell D, Peterson J, Welch V, Losos M et al (2000) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. OHRI, Ottawa

Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560CrossRefPubMedPubMedCentral

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefPubMed

Woolf B (1955) On estimating the relation between blood group and disease. Ann Hum Genet 19:251–253CrossRefPubMed

10.

Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634CrossRefPubMedPubMedCentral

11.

Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50:1088–1101CrossRefPubMed

12.

Scifres C, Feghali M, Althouse AD, Caritis S, Catov J (2015) Adverse outcomes and potential targets for intervention in gestational diabetes and obesity. Obstet Gynecol 126:316–325CrossRefPubMed

13.

Li S, Rosenberg L, Palmer JR, Phillips GS, Heffner LJ, Wise LA (2013) Central adiposity and other anthropometric factors in relation to risk of macrosomia in an African American population. Obesity 21:178–184CrossRefPubMedPubMedCentral

14.

Djelantik AA, Kunst AE, van der Wal MF, Smit HA, Vrijkotte TG (2012) Contribution of overweight and obesity to the occurrence of adverse pregnancy outcomes in a multi-ethnic cohort: population attributive fractions for Amsterdam. Int J Obstet Gynaecol 119:283–290CrossRef

15.

Khashan AS, Kenny LC (2009) The effects of maternal body mass index on pregnancy outcome. Eur J Epidemiol 24:697–705CrossRefPubMed

16.

Tsai YL, Chong KM, Seow KM (2013) Following the 2009 American Institute of Medicine recommendations for normal body mass index and overweight women led to an increased risk of fetal macrosomia among Taiwanese women. Taiwan J Obstet Gynecol 52:341–346CrossRefPubMed

17.

Harper LM, Renth A, Cade WT, Colvin R, Macones GA, Cahill AG (2014) Impact of obesity on maternal and neonatal outcomes in insulin-resistant pregnancy. Am J Perinatol 31:383–388PubMed

18.

Wahabi HA, Fayed AA, Alzeidan RA, Mandil AA (2014) The independent effects of maternal obesity and gestational diabetes on the pregnancy outcomes. BMC Endocr Disord 14:47CrossRefPubMedPubMedCentral

19.

Ferrara A, Weiss NS, Hedderson MM, Quesenberry CP Jr, Selby JV, Ergas IJ et al (2007) Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia. Diabetologia 50:298–306CrossRefPubMed

20.

Liu Y, Dai W, Dai X, Li Z (2012) Prepregnancy body mass index and gestational weight gain with the outcome of pregnancy: a 13-year study of 292,568 cases in China. Arch Gynecol Obstet 286:905–911CrossRefPubMed

21.

Heude B, Thiebaugeorges O, Goua V, Forhan A, Kaminski M, Foliguet B et al (2012) Pre-pregnancy body mass index and weight gain during pregnancy: relations with gestational diabetes and hypertension, and birth outcomes. Matern Child Health J 16:355–363CrossRefPubMedPubMedCentral

22.

Tabet M, Flick LH, Tuuli MG, Macones GA, Chang JJ (2015) Prepregnancy body mass index in a first uncomplicated pregnancy and outcomes of a second pregnancy. Am J Obstet Gynecol 213(548):e1–e7

23.

Ouzounian JG, Hernandez GD, Korst LM, Montoro MM, Battista LR, Walden CL et al (2011) Pre-pregnancy weight and excess weight gain are risk factors for macrosomia in women with gestational diabetes. J Operinatol 31:717–721CrossRef

24.

Black MH, Sacks DA, Xiang AH, Lawrence JM (2013) The relative contribution of prepregnancy overweight and obesity, gestational weight gain, and IADPSG-defined gestational diabetes mellitus to fetal overgrowth. Diabetes Care 36:56–62CrossRefPubMed

25.

Ehrlich SF, Crites YM, Hedderson MM, Darbinian JA, Ferrara A (2011) The risk of large for gestational age across increasing categories of pregnancy glycemia. Am J Obstet Gynecol 204(240):e1–e6

26.

Sridhar SB, Ferrara A, Ehrlich SF, Brown SD, Hedderson MM (2013) Risk of large-for-gestational-age newborns in women with gestational diabetes by race and ethnicity and body mass index categories. Obstet Gynecol 121:1255–1262CrossRefPubMedPubMedCentral

27.

Alberico S, Montico M, Barresi V, Monasta L, Businelli C, Soini V et al (2014) The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study. BMC Pregnancy Childbirth 14:23CrossRefPubMedPubMedCentral

28.

Ahlsson F, Diderholm B, Jonsson B, Norden-Lindberg S, Olsson R, Ewald U et al (2010) Insulin resistance, a link between maternal overweight and fetal macrosomia in nondiabetic pregnancies. Horm Res Paediatr 74:267–274CrossRefPubMed

Titel: Maternal pre-pregnancy obesity and the risk of macrosomia: a meta-analysis
verfasst von: Rui-xue Dai
Xiu-Jie He
Chuan-Lai Hu
Publikationsdatum: 28.10.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 1/2018
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4573-8

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