Maternal Obesity and Occurrence of Fetal Macrosomia: A Systematic Review and Meta-Analysis

Abstract

Objective. To determine a precise estimate for the contribution of maternal obesity to macrosomia. Data Sources. The search strategy included database searches in 2011 of PubMed, Medline (In-Process & Other Non-Indexed Citations and Ovid Medline, 1950–2011), and EMBASE Classic + EMBASE. Appropriate search terms were used for each database. Reference lists of retrieved articles and review articles were cross-referenced. Methods of Study Selection. All studies that examined the relationship between maternal obesity (BMI ≥30 kg/m2) (pregravid or at 1st prenatal visit) and fetal macrosomia (birth weight ≥4000 g, ≥4500 g, or ≥90th percentile) were considered for inclusion. Tabulation, Integration, and Results. Data regarding the outcomes of interest and study quality were independently extracted by two reviewers. Results from the meta-analysis showed that maternal obesity is associated with fetal overgrowth, defined as birth weight ≥ 4000 g (OR 2.17, 95% CI 1.92, 2.45), birth weight ≥4500 g (OR 2.77,95% CI 2.22, 3.45), and birth weight ≥90% ile for gestational age (OR 2.42, 95% CI 2.16, 2.72). Conclusion. Maternal obesity appears to play a significant role in the development of fetal overgrowth. There is a critical need for effective personal and public health initiatives designed to decrease prepregnancy weight and optimize gestational weight gain.

Prevalence of vitamin B-12 insufficiency during pregnancy and its effect on offspring birth weight: a systematic review and meta-analysis

“…In addition, obesity rates are high in these regions (119), and obesity has been shown to be associated with low vitamin B-12 (79,(120)(121)(122). The link between obesity, gestational diabetes, and low vitamin B-12 concentrations has not been fully explored, but because the former 2 conditions are independently associated with fetal macrosomia, they may partly compensate for or mask the associations between vitamin B-12 and LBW (123,124).…”

Choline prevents fetal overgrowth and normalizes placental fatty acid and glucose metabolism in a mouse model of maternal obesity

“…Many studies have demonstrated that maternal obesity results in fetal overgrowth [1, 5, 38–40] and increases the risk for obesity later in life [4]. Dietary interventions that focused on calorie and glycemic control during pregnancy improved maternal metabolism but often failed to translate into improved fetal growth outcomes, e.g.…”

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review

“…Both higher maternal pregnancy BMI and increased gestational weight gain are well-known risk factors for larger sizes of gestational age infants. A meta-analysis among 13 that, as compared to normal maternal pre-pregnancy weight, maternal pre-pregnancy obesity was associated with a 2-fold higher risk of delivering larger sized gestational age infants [17] . Similarly, a meta-analysis among 15 cohort and case-control studies showed that excessive gestational weight gain based on the IOM criteria was associated with a 2-fold higher risk of macrosomia [18] .…”