Introduction Prolonged pregnancy (PP) and post-term birth(PTB) are preventable causes of perinatal mortality, morbidity andobstetric complications. This systematic review investigates theassociation between maternal body mass index (BMI) and PP/PTB.Methods Database, citations and reference lists were searched.Screening and data extraction were carried out by two researchersindependently. Primary research published in English after 1990was included. Associations were investigated using dose–responseanalyses by computing study-speciﬁc linear trends and 95% CI.The overall odds ratio (OR) was calculated using a random-effectsmodel. A potential nonlinear relationship was assessed using cubicspline regression, and publication bias using Egger’s test.Results Searches identiﬁed 15 931 titles/abstracts: 39 wereincluded (n = 4 143 700 births). Most studies were publishedbetween 2005 and 2014 (n = 33), from Europe (n = 20), Middle-East/Asia (n = 9), USA (n = 5), Canada (n = 3), Australia (n = 1)and South Africa (n = 1). Meta-analyses were possible in 19 PTBstudies (n = 2 523 199), and ten PP studies (n = 441 346). Linearanalyses showed a signiﬁcantly increased association between each5-unit BMI increase and PP (OR 1.13; 95% CI 1.04–1.22) andPTB (OR 1.18; 95% CI 1.11–1.26). The ORs of PTB increasedwith increasing obesity classiﬁcations: BMI 30–34.9 kg/m21.36;35.0–39.9 kg/m21.54; 40.0–44.9 kg/m21.72; 45.0–50 kg/m21.90.No signiﬁcant publication bias was identiﬁed for either PTB(P = 0.60) or PP (P = 0.18).Conclusion This meta-analysis identiﬁed a signiﬁcant associationbetween maternal obesity and PTB/PP. The results suggest thatthe odds of women with obesity having a PTB increases from36% to 90% depending on the obesity classiﬁcation. Thedifferential association between the obesity classiﬁcations shouldbe considered when planning care to prevent adverse outcomesassociated with PTB.
|Journal||BJOG-An International Journal of Obstetrics and Gynaecology|
|Publication status||Published - 2016|
|Event||British Maternal & Fetal Medicine Society (BMFMS) 18th Annual Conference 2016 - |
Duration: 21 Apr 2016 → …