title: Maternal obesity in Europe: where do we stand and how to move forward?: A scientific paper commissioned by the European Board and College of Obstetrics and Gynaecology (EBCOG).
abstract: Paralleling the global epidemic of obesity figures in the general population, the incidence of maternal obesity (BMI>30kg/m(2) at the start of pregnancy) has been rising over the last world. While most European countries do not systematically report obesity figures in their pregnant population, the prevalence of maternal obesity varies from 7 to 25% and seems strongly related to social and educational inequalities. Obesity during pregnancy represents an important preventable risk factor for adverse pregnancy outcomes and is associated with negative long-term health outcomes for both mothers and offspring. These effects are often aggravated by the high incidence of abnormal glucose tolerance and excessive gestational weight gain found in this group. The main controversies around the management of the obese pregnant women are related to (1) the value of repeated weighing during pregnancy, (2) the optimal gestational weight gain to advise and the lifestyle messages to deliver in order to achieve this, (3) the optimal strategy and timing of screening for gestational diabetes (GDM) and (4) the optimal timing and mode of delivery. These controversies are reviewed in this review, with the exception of screening for gestational diabetes that is discussed extensively elsewhere in this issue (Benhalima et al.). An agenda for research is proposed with the hope that it will catch the attention of policy-makers and funders and ultimately lead to the development of European-wide evidence-based guidelines for clinicians.
authors.affiliation: Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals KU Leuven, Leuven, Belgium; Department of Obstetrics, Gynecology and Fertility, GZA Sint-Augustinus, Wilrijk, Belgium. Electronic address: roland.devlieger@uzleuven.be.
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
authors.affiliation: Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: Benhalima
authors.affiliation: Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, The Clinical Institute of Medicine, Faculty of Health and Medicine Sciences, University of Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Damm
authors.affiliation: Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium; Department of Obstetrics and Gynecology, University Hospitals KU Leuven, Leuven, Belgium.
authors.forename: André
authors.initials: A
authors.lastname: Van Assche
authors.affiliation: Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Belgium.
authors.forename: Chantal
authors.initials: C
authors.lastname: Mathieu
authors.affiliation: Department of Obstetrics & Gynecology, Victoria Hospital, Kirkcaldy, Scotland, UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Mahmood
authors.affiliation: Endocrinology School of Medicine and Galway Diabetes Research Centre (GDRC), National University of Ireland, Galway (NUIG), Ireland.
authors.forename: Fidelma
authors.initials: F
authors.lastname: Dunne
authors.affiliation: Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium; Faculty of Health and Social Work, Research Unit Healthy Living, UC Leuven-Limburg, Belgium; Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Belgium.
authors.forename: Annick
authors.initials: A
authors.lastname: Bogaerts
mesh_terms: D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D009774:Obstetrics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*
keywords: EBCOG; Epidemiology; Europe; Maternal obesity; Preconception; Prevention