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Cited by 22Gestational Diabetes Research and ManagementBirth, Development, and HealthObesity, Physical Activity, Diet

Maternal adiposity and perinatal and offspring outcomes: an umbrella review

Yang, Ziyi, Feng, Gengchen, Gao, Xueying, Yan, Xueqi, Li, Yimeng, Wang, Yuteng, Li, Shumin, Jiang, Yonghui +3 more·2024·Nature Human Behaviour
DOI 10.1038/s41562-024-01994-6
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Abstract

Maternal adiposity deleteriously affects obstetrical health and has been associated with long-term adverse consequences in offspring. Here we conducted an umbrella review encompassing 194 observational meta-analyses, 10 Mendelian randomization studies and 748 interventional meta-analyses to appraise the published evidence on the associations between maternal adiposity and perinatal and offspring outcomes. Evidence grading suggested that 17 (8.8%) observational meta-analyses were supported by convincing evidence for 12 outcomes: maternal adiposity was associated with an increased risk of caesarean delivery following labour induction, infant mortality, Apgar score <7 at 1 min, antenatal depression, offspring overweight and obesity, early timing of puberty onset in daughters, attention deficit hyperactivity disorder, cerebral palsy, congenital heart disease and spina bifida (OR/RR ranging from 1.14 to 2.31), as well as increased offspring body fat percent and fat mass (SMD 0.31 and 0.35, respectively). Among these outcomes, interventional meta-analyses supported that maternal weight loss interventions significantly reduced the risk of antenatal depression but not low Apgar scores; these interventions also could not reduce offspring fat mass or body fat percent. Evidence from Mendelian randomization studies supported a causal relationship between maternal adiposity and gestational diabetes mellitus, preeclampsia, birth size and offspring adiposity. Our findings highlight that while observational meta-analyses reveal associations between maternal adiposity and various adverse perinatal and offspring outcomes, convincing, unbiased evidence or support from Mendelian randomization studies is limited. Maternal pre-conceptional and prenatal weight loss interventions can reduce some, but not all, of these adverse effects.

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Authors
Yang, Z., Feng, G., Gao, X., Yan, X., Li, Y., Wang, Y., Li, S., Jiang, Y., Zhao, S., Zhao, H., & Chen, Z.-J.
Affiliations
Shandong University (CN)
Corresponding author
  • Zhao, Shigang
  • Zhao, Han
  • Chen, Zi-Jiang
ORCID
Venue
Nature Human Behaviour
Publisher
Springer Science and Business Media LLC
Published
2024-10-11
Volume
8
Issue
12
Pages
2406-2422
ISSN
2397-3374 (ISSN-L)
DOI
10.1038/s41562-024-01994-6
OpenAlex
W4403339124
Semantic Scholar
700fbebc33d2d61ed22a924d9f4d29df05b15a9e
Cited by
22
References
120
Citations by year
2026: 11 · 2025: 10 · 2024: 1
FWCI
10.40
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Nature Human Behaviour (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
maternal adiposity, maternal obesity, perinatal outcomes, offspring outcomes, cesarean section, infant mortality, Apgar score, antenatal depression, offspring obesity, puberty onset, attention deficit hyperactivity disorder, cerebral palsy, congenital heart disease, spina bifida, gestational diabetes mellitus, preeclampsia, birth size, fat mass
MeSH terms
Female, Humans, Infant, Newborn, Obesity, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prenatal Exposure Delayed Effects, Meta-Analysis as Topic, Adiposity, Mendelian Randomization Analysis

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