Kurnaz Döndü, Karaçam Zekiye
Marmara University, Faculty of Health Sciences, Division of Midwifery, Istanbul, Turkey.
Aydın Adnan Menderes University, Faculty of Health Sciences, Division of Midwifery, Aydın, Turkey.
Int J Obes (Lond). 2025 Mar 26. doi: 10.1038/s41366-025-01748-y.
This study was conducted to determine the effects of the methods used in the management of maternal obesity on pregnancy and birth outcomes.
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.
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.
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.
本研究旨在确定孕产妇肥胖管理方法对妊娠和分娩结局的影响。
本研究遵循PRISMA声明进行。2021年10月在PubMed、国家论文中心、DergiPark、MEDLINE、Cochrane图书馆和EBSCO搜索引擎中检索用于荟萃分析的文章，并于2023年9月更新。使用ROB2评估研究的方法学质量。采用荟萃分析对数据进行综合，并使用GRADE方法对证据的确定性和推荐的强度进行评级。本研究纳入了2013年至2021年间发表的21项研究。这些研究的总样本量为7695。
体重管理干预措施显著降低了孕期体重增加（p<0.001）和出生体重（p<0.01）。对综合分析中纳入的其他不良妊娠结局没有影响（p>0.05）。亚组分析表明，发放宣传册的方法导致出生体重水平较低（p<0.01）和孕期体重增加较少（p<0.001）；使用二甲双胍与新生儿重症监护病房入院率显著下降相关（p<0.01）；运动方法与妊娠期糖尿病发生率较低（p<0.001）、孕期体重增加较少（p<0.001）、出生体重较低（p=0.01）和大于胎龄儿出生发生率较低（p<0.05）相关，而饮食和运动相结合显著降低了孕期体重增加（p=0.001）。使用GRADE评估的所有15个关键结局的证据确定性均为高。
该研究表明，孕产妇肥胖治疗方法可能会减少一些孕产妇和新生儿的不良结局，但以理想体重开始妊娠更为重要。
