title: Maternal adiposity as an independent risk factor for pre-eclampsia: a meta-analysis of prospective cohort studies.
abstract: Studies investigating the association between maternal adiposity and risk of pre-eclampsia showed contradictory results. Therefore, we performed a meta-analysis of prospective cohort studies to estimate the effect of maternal adiposity on pre-eclampsia. We reviewed 1,286 abstracts and finally included 29 prospective cohort studies with 1,980,761 participants and 67,075 pre-eclampsia events. We pooled data with a random-effects model, and obtained risk estimates for five predetermined bodyweight groups: low, normal-weight (reference), overweight, obese and severely obese. In the cohort studies that unadjusted for pre-eclampsia risk factors, the pooled unadjusted relative risks (RR) with 95% confidence intervals (95%CI) for pre-eclampsia of overweight, obese and severely obese women were 1.58 (95% CI 1.44-1.72, P < 0.001), 2.68 (95% CI 2.39-3.01, P < 0.001) and 3.12 (95% CI 2.24-4.36, P < 0.001), respectively. In those cohorts that adjusted for pre-eclampsia risk factors, the pooled unadjusted RRs for pre-eclampsia of overweight, obese and severely obese women were 1.70 (95% CI 1.60-1.81, P < 0.001), 2.93 (95% CI 2.58-3.33, P < 0.001) and 4.14 (95% CI 3.61-4.75, P < 0.001), respectively. Sensitivity analysis showed maternal adiposity was associated with increased risk of pre-eclampsia in both nulliparous and multiparas women. In conclusion, overweight or obese pregnant women have a substantially increased risk of pre-eclampsia, and maternal adiposity is an independent risk factor of pre-eclampsia.
authors.affiliation: Department of Obstetrics, Maternal and Children Health's Hospital, Weifang, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.forename: P
authors.initials: P
authors.lastname: Wang
authors.forename: H
authors.initials: H
authors.lastname: Liu
authors.forename: X
authors.initials: X
authors.lastname: He
authors.forename: J
authors.initials: J
authors.lastname: Zhang
authors.forename: H
authors.initials: H
authors.lastname: Yan
authors.forename: D
authors.initials: D
authors.lastname: Xu
authors.forename: B
authors.initials: B
authors.lastname: Wang
mesh_terms: D050154:Adiposity / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010298:Parity; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors