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Meta-Analysis
. 2020 Apr 2:2020:6303820.
doi: 10.1155/2020/6303820. eCollection 2020.

Relationship between Maternal Central Obesity and the Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Cohort Studies

Da Yao  1   2 , Qing Chang  1   2 , Qi-Jun Wu  1   2 , Shan-Yan Gao  1   2 , Huan Zhao  1   2 , Ya-Shu Liu  1   2 , Yu-Ting Jiang  1   2 , Yu-Hong Zhao  1   2
Affiliations
Meta-Analysis

Relationship between Maternal Central Obesity and the Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Cohort Studies

Da Yao et al. J Diabetes Res. .

Abstract

Objective: Nowadays, body mass index (BMI) is used to evaluate the risk stratification of obesity-related pregnancy complications in clinics. However, BMI cannot reflect fat distribution or the proportion of adipose to nonadipose tissue. The objective of this study is to evaluate the association of maternal first or second trimester central obesity with the risk of GDM. Research Design and Methods. We searched in PubMed, Embase, and Web of Science for English-language medical literature published up to 12 May 2019. Cohort studies were only included in the search. Abdominal subcutaneous fat thickness, waist circumference, waist-hip ratio or body fat distribution were elected as measures of maternal central obesity, and all diagnostic criteria for GDM were accepted. The random effect meta-analysis was performed to evaluate the relationship between central obesity and the risk of GDM.

Results: A total of 11 cohort studies with an overall sample size of 27,675 women and 2,226 patients with GDM were included in the analysis. The summary estimate of GDM risk in the central obesity pregnant women was 2.76 (95% confidence interval [CI]: 2.35-3.26) using the adjusted odds ratio (OR). The degree of heterogeneity among the studies was low (I 2 = 14.4, P = 0.307). The subgroup analyses showed that heterogeneity was affected by selected study characteristics (methods of exposure and trimesters). After adjusting for potential confounds, the OR of adjusted BMI was significant (OR = 3.07, 95% CI: 2.35-4.00).

Conclusions: Our findings indicate that the risk of GDM was positively associated with maternal central obesity.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Forest plots (random effect model) of meta-analysis on the association between the concentration of central obesity and risk of GDM.
Figure 3
Figure 3
Funnel plot of included studies for potential publication bias.
Figure 4
Figure 4
Sensitivity analysis of included studies.
See this image and copyright information in PMC

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