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Dose-response association between maternal body mass index and small for gestational age: a meta-analysis
1a Department of Medicine and Public Health , Nagoya Medical Science Research Institute , Nagoya , Japan.
Objective:
This study was performed to determine the dose-response relationships between maternal anthropometric variables and risk of small for gestational age (SGA).
Methods:
Linear and nonlinear dose-response meta-analyses were performed to summarize the adjusted relative risks of SGA. Ten databases, including PubMed (MEDLINE), were searched. Study quality was assessed using the Newcastle-Ottawa scale.
Results:
A total of 323 243 subjects were extracted from high-quality studies to evaluate maternal body mass index (BMI) (n = 9). The generalizability of the findings regarding height and weight (n = 3 and 2, respectively) was limited. The non-linear model (p for non-linearity < 0.05) showed a significant and inverse association of maternal BMI with risk of SGA, although only two of nine studies involved obese women (i.e. BMI ≥ 30 kg/m2). The slope of the dose-response curve between maternal BMI and SGA (i.e. the amount of reduction in SGA risk) decreased gradually.
Conclusions:
SGA risk may be reduced by increasing BMI of normal (i.e. 18.5 kg/m2 ≤ BMI < 25 kg/m2) and overweight women (i.e. 25 kg/m2 ≤ BMI < 30 kg/m2), but the most marked reduction is achieved by increasing BMI of underweight women (i.e. BMI < 18.5 kg/m2).
