Predictors of Adverse Pregnancy Outcomes in Pregnant Women Living with Obesity: A Systematic Review

Romina Fakhraei, Kathryn Denize, Alexandre Simon, Ayni Sharif, Julia Zhu-Pawlowsky, Alysha L.J. Dingwall-Harvey, Brian Hutton, Misty Pratt, Becky Skidmore, Nadera Ahmadzai, Nicola Heslehurst, Louise Hayes, Angela C. Flynn, Maria P. Velez, Graeme Smith, Andrea Lanes, Natalie Rybak, Mark Walker, Laura Gaudet*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Obesity is a well-recognized risk factor for pregnancy complications. Most studies to date are in large cohorts, with results presented in a way that assumes all women living with obesity are at equal risk. This study investigates which women living with obesity are at higher risk of specific pregnancy complications. A systematic search of MEDLINE and Embase identified 7894 prospective or retrospective cohort studies exploring predictors of adverse outcomes among pregnant women living with obesity. Following screening, 61 studies were deemed eligible. Studies were selected if the effects of exposure to any predictor amongst pregnant women living with obesity could be collected. Maternal characteristics assessed for association with adverse outcomes included maternal age, race/ethnicity, maternal height, mode of conception, complement activation factors, and history of various comorbidities/procedures. Gestational diabetes mellitus was the most studied outcome (n = 32), followed by preterm birth (n = 29), preeclampsia (n = 27), low birthweight infants (n = 20), small for gestational age newborns (n = 12), and stillbirth (n = 7). This review identified important characteristics that should be considered during the screening and follow-up sessions of pregnant women living with obesity, including pre-existing type 1 diabetes, maternal age <20 years or ≥35 years, non-White ethnicity, abdominal adiposity obesity, and history of bariatric surgery.

Original languageEnglish
Article number2063
JournalInternational Journal of Environmental Research and Public Health
Issue number4
Publication statusPublished - 1 Feb 2022


  • Adverse outcomes
  • Obesity
  • Predictors
  • Pregnancy


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