Measuring and Managing Obesity in Pregnancy Using the Edmonton Obesity Staging System: A Scoping Review

Emerging evidence and clinical practice guidelines have highlighted that obesity, defined as a chronic disease characterised by excess or dysfunctional adipose tissue, may not be accurately measured or understood by solely relying on body mass index (BMI) which is a measure of size not functionality. An alternative to BMI, as proposed in the Canadian Adult Obesity Management Guideline, is the use of the Edmonton Obesity Staging System (EOSS). While the EOSS has been evaluated in both adult and paediatric populations, pregnant individuals remain an underrepresented clinical group in its application. Prenatal care relies on BMI for measurement of maternal obesity; however, the EOSS may be an adjunct or alternative method to consider. This scoping review aimed to summarise previous research on EOSS in pregnancy and to advise future directions. Only three cohort studies were identified, emphasising a critical gap in obesity research. Both BMI and higher EOSS stages (i.e., 3 and 4) were associated with prenatal complications (e.g., preeclampsia, venous thromboembolism, wound complications). Given that EOSS has been used in other populations and is noted to be an effective patient-centred tool to diagnose and manage obesity, future work may explore its use in pregnancy both in comparison to and in conjunction with BMI.