Maternal body mass index and post-term birth: a systematic review and meta-analysis

N Heslehurst; R Vieira; L Hayes; L Crowe; D Jones; S Robalino; E Slack; J Rankin

doi:10.1111/obr.12489

Maternal body mass index and post-term birth: a systematic review and meta-analysis

N Heslehurst^* (Corresponding Author), R Vieira, L Hayes, L Crowe, D Jones, S Robalino, E Slack, J Rankin

^*Corresponding author for this work

Newcastle University

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Abstract

Post-term birth is a preventable cause of perinatal mortality and severe morbidity. This review examined the association between maternal body mass index (BMI) and post-term birth at ≥42 and ≥41 weeks' gestation. Five databases, reference lists and citations were searched from May to November 2015. Observational studies published in English since 1990 were included. Linear and nonlinear dose-response meta-analyses were conducted by using random effects models. Sensitivity analyses assessed robustness of the results. Meta-regression and sub-group meta-analyses explored heterogeneity. Obesity classes were defined as I (30.0-34.9 kg m-2 ), II (35.0-39.9 kg m-2 ) and III (≥40 kg m-2 ; IIIa 40.0-44.9 kg m-2 , IIIb ≥ 45.0 kg m-2 ). Searches identified 16,375 results, and 39 studies met the inclusion criteria (n = 4,143,700 births). A nonlinear association between maternal BMI and births ≥42 weeks was identified; odds ratios and 95% confidence intervals for obesity classes I-IIIb were 1.42 (1.27-1.58), 1.55 (1.37-1.75), 1.65 (1.44-1.87) and 1.75 (1.50-2.04) respectively. BMI was linearly associated with births ≥41 weeks: odds ratio is 1.13 (95% confidence interval 1.05-1.21) for each 5-unit increase in BMI. The strength of the association between BMI and post-term birth increases with increasing BMI. Odds are greatest for births ≥42 weeks among class III obesity. Targeted interventions to prevent the adverse outcomes associated with post-term birth should consider the difference in risk between obesity classes.

Original language	English
Pages (from-to)	293-308
Number of pages	16
Journal	Obesity Reviews
Volume	18
Issue number	3
Early online date	13 Jan 2017
DOIs	https://doi.org/10.1111/obr.12489
Publication status	Published - Mar 2017

Bibliographical note

Acknowledgements
All authors contributed to the design of the research, acquisition of data and writing of the manuscript. NH and JR obtained funding. NH, RV and LH carried out the analysis. The authors would like to acknowledge Dr Helen Simpson at South Tees Hospitals NHS Foundation Trust and Dr Helene Brandon at Gateshead NHS Foundation Trust for their contribution to the clinical relevance and interpretation of this study. Dr Simpson and Dr Brandon are consultant obstetricians with a special interest in maternal obesity and risk management.

This research was part funded by a Medical Research Council and Newcastle University Faculty of Medical Sciences Doctoral Training award for ES. The funders had no role in design and conduct of the study, collection, management, analysis and interpretation of the data and preparation, review or approval of the manuscript.

Keywords

Body Mass Index
Body Weight
Databases, Factual
Female
Gestational Age
Humans
Infant, Newborn
Infant, Postmature
Mothers
Non-Randomized Controlled Trials as Topic
Obesity
Observational Studies as Topic
Pregnancy
Pregnancy Complications
Socioeconomic Factors
Journal Article
Meta-Analysis
Review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/obr.12489Licence: CC BY

Maternal body mass index and post‐term birth
© 2017 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/
Final published version, 748 KBLicence: CC BY

Rute Gomes Velosa Vieira
- School of Medicine, Medical Sciences & Nutrition, Applied Health Sciences - Senior Lecturer
- School of Medicine, Medical Sciences & Nutrition, Medical Statistics
Person: Academic

Cite this

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title = "Maternal body mass index and post-term birth: a systematic review and meta-analysis",

abstract = "Post-term birth is a preventable cause of perinatal mortality and severe morbidity. This review examined the association between maternal body mass index (BMI) and post-term birth at ≥42 and ≥41 weeks' gestation. Five databases, reference lists and citations were searched from May to November 2015. Observational studies published in English since 1990 were included. Linear and nonlinear dose-response meta-analyses were conducted by using random effects models. Sensitivity analyses assessed robustness of the results. Meta-regression and sub-group meta-analyses explored heterogeneity. Obesity classes were defined as I (30.0-34.9 kg m-2 ), II (35.0-39.9 kg m-2 ) and III (≥40 kg m-2 ; IIIa 40.0-44.9 kg m-2 , IIIb ≥ 45.0 kg m-2 ). Searches identified 16,375 results, and 39 studies met the inclusion criteria (n = 4,143,700 births). A nonlinear association between maternal BMI and births ≥42 weeks was identified; odds ratios and 95% confidence intervals for obesity classes I-IIIb were 1.42 (1.27-1.58), 1.55 (1.37-1.75), 1.65 (1.44-1.87) and 1.75 (1.50-2.04) respectively. BMI was linearly associated with births ≥41 weeks: odds ratio is 1.13 (95% confidence interval 1.05-1.21) for each 5-unit increase in BMI. The strength of the association between BMI and post-term birth increases with increasing BMI. Odds are greatest for births ≥42 weeks among class III obesity. Targeted interventions to prevent the adverse outcomes associated with post-term birth should consider the difference in risk between obesity classes.",

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author = "N Heslehurst and R Vieira and L Hayes and L Crowe and D Jones and S Robalino and E Slack and J Rankin",

note = "Acknowledgements All authors contributed to the design of the research, acquisition of data and writing of the manuscript. NH and JR obtained funding. NH, RV and LH carried out the analysis. The authors would like to acknowledge Dr Helen Simpson at South Tees Hospitals NHS Foundation Trust and Dr Helene Brandon at Gateshead NHS Foundation Trust for their contribution to the clinical relevance and interpretation of this study. Dr Simpson and Dr Brandon are consultant obstetricians with a special interest in maternal obesity and risk management. This research was part funded by a Medical Research Council and Newcastle University Faculty of Medical Sciences Doctoral Training award for ES. The funders had no role in design and conduct of the study, collection, management, analysis and interpretation of the data and preparation, review or approval of the manuscript.",

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AU - Jones, D

AU - Robalino, S

AU - Slack, E

AU - Rankin, J

N1 - Acknowledgements All authors contributed to the design of the research, acquisition of data and writing of the manuscript. NH and JR obtained funding. NH, RV and LH carried out the analysis. The authors would like to acknowledge Dr Helen Simpson at South Tees Hospitals NHS Foundation Trust and Dr Helene Brandon at Gateshead NHS Foundation Trust for their contribution to the clinical relevance and interpretation of this study. Dr Simpson and Dr Brandon are consultant obstetricians with a special interest in maternal obesity and risk management. This research was part funded by a Medical Research Council and Newcastle University Faculty of Medical Sciences Doctoral Training award for ES. The funders had no role in design and conduct of the study, collection, management, analysis and interpretation of the data and preparation, review or approval of the manuscript.

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KW - Non-Randomized Controlled Trials as Topic

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KW - Pregnancy Complications

KW - Socioeconomic Factors

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KW - Review

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JO - Obesity Reviews

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ER -

Maternal body mass index and post-term birth: a systematic review and meta-analysis

Abstract

Bibliographical note

Keywords

UN SDGs

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Rute Gomes Velosa Vieira

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