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Obes Rev. 2015 Sep;16(9):758-70. doi: 10.1111/obr.12293. Epub 2015 Jun 11.

Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis.

Author information

1
Department of Global Health Policy, The University of Tokyo, Tokyo, Japan.
2
Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh.
3
Department of Health Policy, National Centre for Child Health and Development, Tokyo, Japan.

Abstract

We conducted a systematic review and meta-analysis of population-based cohort studies of maternal body mass index (BMI) and risk of adverse birth and health outcomes in low- and middle-income countries. PubMed, Embase, CINAHL and the British Nursing Index were searched from inception to February 2014. Forty-two studies were included. Our study found that maternal underweight was significantly associated with higher risk of preterm birth (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01-1.27), low birthweight (OR, 1.66; 95% CI, 1.50-1.84) and small for gestational age (OR, 1.85; 95% CI, 1.69-2.02). Compared with mothers with normal BMI, overweight or obese mothers were at increased odds of gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, caesarean delivery and post-partum haemorrhage. The population-attributable risk (PAR) indicated that if women were entirely unexposed to overweight or obesity during the pre-pregnancy or early pregnancy period, 14% to 35% fewer women would develop gestational diabetes, pre-eclampsia or pregnancy-induced hypertension in Brazil, China, India, Iran or Thailand. The highest PAR of low birthweight attributable to maternal underweight was found in Iran (20%), followed by India (18%), Thailand (10%) and China (8%). Treatment and prevention of maternal underweight, overweight or obesity may help reduce the burden on maternal and child health in developing countries.

KEYWORDS:

Low- and middle-income countries; maternal BMI; population-attributable risk; pregnancy and health outcomes

PMID:
26094567
DOI:
10.1111/obr.12293
[Indexed for MEDLINE]

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