Obesity and gynaecological and obstetric conditions: umbrella review of the literature.

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Term Occurence Count Dictionary
polycystic ovary syndrome 1 endocrinologydiseases
childhood obesity 1 endocrinologydiseases
diabetes mellitus 4 endocrinologydiseases
hyperinsulinemia 1 endocrinologydiseases
obesity 30 endocrinologydiseases

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childhood obesity 5923 outcome was not relevant to clinical obstetrics and gynaecology (such as congenital malformations or childhood obesity and age at menarche), single arm meta-analyses that did not contain a comparison group, prognostic studies
diabetes mellitus 22098 with adjusted risk estimates; BMI=body mass index; COC=combined oral contraceptive; GDM=gestational diabetes mellitus ; GWG=gestational weight gain; HC=hip circumference; HRT=hormone replacement therapy; iya=in young adulthood;
diabetes mellitus 26790 (n=3), macrosomia (n=3), low Apgar score at one and five minutes (n=3), stillbirth (n=1), gestational diabetes mellitus (n=2), instrumental delivery (n=1), postpartum haemorrhage (n=1), postpartum weight retention (n=1),
diabetes mellitus 32572 based on assumption made for plausible effect size; SGA=small for gestational age; GDM=gestational diabetes mellitus ; PPH=postpartum haemorrhage; PPWR=postpartum weight retention; PTB=preterm birth; adj=effect estimate
diabetes mellitus 38325 interventions resulted in significant reduction in the rates of large for gestational age, gestational diabetes mellitus , postpartum weight retention, pre-eclampsia, and preterm birth in at least one meta-analysis. The rates
hyperinsulinemia 42630 from recent Mendelian randomisation studies, in which increasing BMI (but not waist to hip ratio), hyperinsulinemia , and genetically predicted higher BMI were found to be causally associated with risk of endometrial
obesity 3022 children has risen globally from about 857 million in 1980 to 2.1 billion in 2013, and the prevalence of obesity in women has more than doubled within the past four decades.[1] In most European countries more than
obesity 3805 birth, and congenital anomalies, a lower initiation rate and shorter duration of breast feeding, and obesity and cardiometabolic morbidity in adult life.[10][11][12][13]Although many of the suggested associations
obesity 5050 obstetrics and gynaecology. Adiposity was defined as excess accumulation of fat and was used to capture all obesity indices assessed: body mass index (BMI), weight, weight gain, gestational weight gain, waist to hip
obesity 5933 not relevant to clinical obstetrics and gynaecology (such as congenital malformations or childhood obesity and age at menarche), single arm meta-analyses that did not contain a comparison group, prognostic studies
obesity 6237 diagnosis of gynaecological cancer or another gynaecological condition, and meta-analyses assessing obesity as a predictive variable or screening test.Meta-analyses that did not present comprehensive study specific
obesity 9428 tailed.Fig 1 Graphical presentation of main and sensitivity analyses of meta-analyses investigating obesity and gynaecological and obstetric conditionsPatient involvementNo patients were involved in setting the
obesity 11005 (2.7%) were case series.Fig 2 Identification and inclusion of observational meta-analyses investigating obesity and gynaecological and obstetric conditionsThese 156 meta-analyses included associations between eight
obesity 17566 meta-analyses (11/144) met the criteria for strong evidence (table 2): they examined associations between obesity and increased risk of endometrial cancer (n=2), ovarian cancer (n=1), fetal macrosomia (n=1), low Apgar
obesity 18315 women with BMI >35 compared with <25.Table 1Summary of evidence grading for meta-analyses associating obesity and risk of obstetric and gynaecological morbidity from cohort studies. Risk are for incidences unless
obesity 23677 size.Table 2Details of associations supported by strong evidence in meta-analyses of cohort studies on obesity and risk of obstetric and gynaecological morbidity. Outcomes are incidences unless stated otherwise.
obesity 26564 meta-analyses were supported by highly suggestive evidence (32/144, 22%) and evaluated associations between obesity and increase in risk of miscarriage among women undergoing IVF, endometrial cancer (n=9), large for
obesity 27130 3Details of associations supported by highly suggestive evidence in meta-analyses of cohort studies on obesity and risk of obstetric and gynaecological morbidity. Outcomes are incidences unless stated otherwise.
obesity 37503 with adiposity in the observational meta-analysis, though it decreased with interventions that reduced obesity .Out of eight outcomes that met the strong criteria in observational studies, only three were studied
obesity 37664 observational studies, only three were studied in meta-analyses of interventions that could reduce obesity . These interventions were found to significantly reduce the rates of total caesarean section and pre-eclampsia,
obesity 39613 suggestive evidence for 32 associations that included risks of these outcomes with various other indices of obesity and, in addition, new outcomes that included the rate of miscarriage among women undergoing IVF, fetal
obesity 40639 haemorrhage. We did not find any meta-analyses that explored the impact of interventions that reduce obesity on the risk of miscarriage after IVF, any type of endometrial or ovarian cancer, antenatal depression,
obesity 40835 antenatal depression, or emergency caesarean section.Two recent reviews with narrative analysis associated obesity with at least 22 pregnancy related outcomes.[10][78] Nineteen out of these 22 outcomes have been assessed
obesity 41606 evidence.One of the most prominent associations identified in the current umbrella review was that between obesity and risk of endometrial cancer, for which two meta-analyses met the criteria for strong and nine for
obesity 44845 higher birth weight in offspring.[86] Macrosomia at birth has important implications, with links to obesity later in life[87] as well as obstetric complications (such as shoulder dystocia, caesarean delivery,
obesity 45884 low Apgar score at birth were supported by strong and highly suggestive evidence, probably because obesity predisposes to higher risk of gestational diabetes, pre-eclampsia, and fetal macrosomia.The association
obesity 46004 to higher risk of gestational diabetes, pre-eclampsia, and fetal macrosomia.The association between obesity and risk of gestational diabetes was supported by highly suggestive evidence. The summary effect estimates
obesity 46917 meta-analyses that documented significant reductions in the risk of pre-eclampsia by interventions that reduce obesity , which predominantly had a low risk of bias.Meta-analyses of interventions that reduce obesity (such
obesity 47012 reduce obesity, which predominantly had a low risk of bias.Meta-analyses of interventions that reduce obesity (such as dietary interventions or physical exercise) have been shown to reduce gestational weight gain,[58][63][65][66][67][68][69][72]
obesity 49964 a negative test for bias does not exclude the potential for bias.ConclusionThe association between obesity and the risk of any obstetric or gynaecological morbidity has been extensively studied. Observational
obesity 50095 obstetric or gynaecological morbidity has been extensively studied. Observational associations between obesity and risk of eight outcomes are supported by strong evidence, but for only two of them (total caesarean
obesity 50515 in many of the explored associations and the number of interventional meta-analyses is limited. With obesity becoming a global epidemic, the assessment of the strength of the evidence supporting the impact of
obesity 51314 women are obese, including while pregnantSeveral meta-analyses have studied the association between obesity and any gynaecological or obstetric morbidity and the effect of weight loss interventions on these outcomesThe
obesity 51729 appraisal of the literature exploring the strength and validity of the published associations between obesity , interventions to reduce it, and the risk of obstetric and gynaecological morbidityIn 258 observational
obesity 51911 morbidityIn 258 observational or interventional meta-analyses that assessed the association between obesity and the incidence of 84 different obstetric or gynaecological outcome there was strong evidence to support
obesity 52050 different obstetric or gynaecological outcome there was strong evidence to support the association between obesity and increased risk of only eight outcomes (risk of endometrial and ovarian cancer, fetal macrosomia,
polycystic ovary syndrome 3377 gynaecological cancers,[3][4][5] poor survival from gynaecological cancer,[6][7] increased incidence of polycystic ovary syndrome ,[8] and infertility.[9] Obesity before and during pregnancy is associated with multiple health conditions

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