The effect of methods used in the management of maternal obesity on pregnancy and birth outcomes: a systematic review with meta-analysis.

Abstract

Aim: This study was conducted to determine the effects of the methods used in the management of maternal obesity on pregnancy and birth outcomes.

Materials and methods: This study was conducted following the PRISMA Statement. The articles to be used in the meta-analysis were searched in PubMed, National Thesis Center, DergiPark, MEDLINE, Cochrane Library and EBSCO search engines in October 2021 and updated in September 2023. The methodological qualities of the studies were evaluated using ROB2. The data were synthesized using meta-analysis, and the GRADE approach was used to rate the certainty of the evidence and the strength of the recommendations. Twenty-one studies published between 2013 and 2021 were included in the study. The total sample size of the studies was 7695.

Results: Weight management interventions significantly reduced weight gain during pregnancy (p < 0.001) and birth weight (p < 0.01). Did not affect other adverse pregnancy outcomes included in the synthesis (p > 0.05). The subgroup analyses showed that the method of handing out brochures resulted in lower levels of birth weight (p < 0.01) and weight gained during pregnancy (p < 0.001); the use of metformin was associated with a significant drop in admissions to the neonatal intensive care unit (p < 0.01); the method of exercise was associated with lower in gestational diabetes (p < 0.001), weight gained during pregnancy (p < 0.001), birth weight (p = 0.01) and large-for-gestational-age baby birth (p < 0.05), while and the combination of diet and exercise significantly reduced weight gained during pregnancy (p = 0.001). The certainty of evidence assessed using GRADE for all 15 critical outcomes was high 15 outcomes.

Conclusion: The study revealed that methods used in the treatment of maternal obesity may reduce some negative maternal and newborn outcomes, but it is more important to start pregnancy with an ideal weight.