A Systematic Review of the Management of Maternal Obesity in Pregnancy: Antenatal Management, Outcomes, and Long-Term Implications on Maternal Health.

Maternal obesity is a looming worldwide health challenge with dire consequences regarding pregnancy outcomes and future maternal and offspring health. This systematic review synthesizes evidence from eight high-quality studies published between 2015 and 2024, discussing the management of maternal obesity during pregnancy, antenatal care strategies, associated perinatal outcomes, and long-term maternal health risks. The review identifies a strong correlation between maternal obesity and the increased chances for gestational diabetes mellitus (GDM), hypertensive disorders, preterm birth, cesarean delivery, and neonatal morbidity, including large for gestational age (LGA) infants and congenital anomalies. Moreover, there are long-term maternal impacts of increased chances for type 2 diabetes mellitus and cardiovascular disorders. Also, there is an increased risk of metabolic and neurodevelopmental disorders for the offspring. There are significant differences in the antenatal management strategies in settings with conflicting clinical guidelines on the issues of gestational weight gain, screening protocols, and lifestyle counseling. The early pregnancy holds promises in the improvement of outcomes in multidisciplinary interventions, but implementation is still limited. A predictive risk model based on maternal comorbidities, age, and pattern of fat distribution may provide a foundation for individual treatment and needs to be validated. As outlined in the review, the need for standardized and evidence-based guidelines for coordinated antenatal care is emphasized to reduce the harmful effects of maternal obesity. It is crucial not only for the improvement of maternal and neonatal outcomes but also from the viewpoint of breaking the intergenerational cycle of obesity- related health issues.