Association between pre-pregnancy body mass index and gestational weight gain and the risk of preeclampsia: A systematic review and meta-analysis

Abstract

Objective: To analyze the relationship between body mass index (BMI) before pregnancy and gestational weight gain throughout pregnancy with the incidence of preeclampsia. Methods: This was a systematic review-meta analysis of literature collected from three e-databases: Scopus, PubMed, and Science Direct. Quality assessment was measured with the Effective Public Health Practice Project methods. Meta-analysis was done by calculating the fixed and random-effects of odds ratio (OR) for each BMI category and gestational weight gain as compared with the incidence of preeclampsia. Results: Overweight was associated with a significantly increased risk of preeclampsia (OR=2.152, 95% CI 1.363-3.400; P=0.001). Obesity was also associated with a noticeably increased risk of preeclampsia (OR=2.856, 95% CI 1.755-4.649; P<0.001). Meanwhile, underweight was associated with a significantly reduced risk of preeclampsia (OR=0.639, 95% CI 0.500-0.817; P<0.001) when compared with normal BMI. Pregnant women who gained weight below the standard throughout pregnancy was a protective factor from preeclampsia (OR=0.813, 95% CI 0.610-1.083; P=0.157) whereas pregnant women who gained weight above the standard had almost doubled risk of preeclampsia (OR=1.850, 95% CI 1.377-2.485; P<0.001). Conclusions: The result of this study affirms the role of overweight-obesity pre-pregnancy, and gestational weight gain above the standard during pregnancy as significant risk factors for developing preeclampsia.