Should antenatal testing be performed in patients with a pre-pregnancy BMI ≥ 35?

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Maternal-Fetal Medicine

Background:

• Elevated body mass index (BMI) is a growing concern in reproductive health.
• Understanding the association between maternal BMI and adverse pregnancy outcomes is crucial for clinical practice.

Purpose of the Study:

• To evaluate the association between elevated body mass index (BMI) and the risk of stillbirth.
• To assess the evidence regarding the effectiveness and safety of antenatal testing in pregnancies with higher BMIs.

Main Methods:

• Review of cohort studies and meta-analyses examining the relationship between BMI and stillbirth.
• Analysis of studies investigating the impact of antenatal testing strategies in high-BMI pregnancies.

Main Results:

• Multiple studies indicate a positive association between elevated BMI and an increased risk of stillbirth (SOR, B).
• Conflicting results exist, with some studies finding a significant association and others not.
• No current evidence demonstrates that increased antenatal testing in higher-BMI pregnancies reduces stillbirth rates.

Conclusions:

• While elevated BMI is linked to a higher risk of stillbirth, the benefits of intensified antenatal surveillance require further investigation.
• The potential harms of unnecessary testing and interventions in higher-BMI pregnancies have not been adequately addressed.