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Obesity in obstetric anesthesia: A systematic review

I Pasca1, L Soloniuk2, C Baker3

  • 1Department of Anesthesiology and Perioperative Medicine, Riverside University Health System, Moreno Valley, CA, USA; Department of Anesthesiology, Loma Linda University, Loma Linda, CA, USA; School of Medicine, University of California Riverside, Riverside, CA, USA; University of California San Diego, La Jolla, CA, USA.

Journal of Gynecology Obstetrics and Human Reproduction
|April 9, 2026
PubMed

Maternal obesity presents complex challenges for anesthetic management, with implications spanning neonatal, cardiovascular, airway, neuraxial, and procedural domains. This review synthesizes evidence on how elevated maternal body mass index (BMI) impacts perioperative evaluations, risks, complications, and outcomes, in addition to anesthetic modalities and efficacy in the pregnant population. Given the increasing global prevalence of maternal obesity, anesthesiologists must refine clinical practices, employing tailored, evidence-based strategies to mitigate risks and enhance patient outcomes. This review aims to provide anesthesiologists and obstetricians with key considerations and best practices for managing obstetric anesthesia patients with obesity. Clinical recommendations herein are based on current research and evaluated using Oxford Centre for Evidence-Based Medicine for level of evidence and class of recommendation.

Keywords:
High-risk pregnancyMitigating riskObesityObstetric anesthesia

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