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Association between maternal prepregnancy body mass index and pregnancy outcomes following assisted reproductive technology: A systematic review and dose–response meta‐analysis
Author(s) -
Xiong Yiquan,
Wang Jing,
Huang Shiyao,
Liu Chunrong,
Liu Yanmei,
Qi Yana,
Li Ling,
Wang Wen,
Zou Kang,
Tan Jing,
Sun Xin
Publication year - 2021
Publication title -
obesity reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.845
H-Index - 162
eISSN - 1467-789X
pISSN - 1467-7881
DOI - 10.1111/obr.13219
Subject(s) - medicine , body mass index , pregnancy , miscarriage , obstetrics , meta analysis , biology , genetics
Summary This systematic review investigated dose–response relationship between maternal prepregnancy body mass index (BMI) and pregnancy outcomes following assisted reproductive technology, including clinical pregnancy rate (CPR), miscarriage rate (MR), and live birth rate (LBR). We searched four major databases and finally included 105 studies involving more than 271,632 pregnant women. We performed linear or nonlinear dose–response meta‐analyses using random effects models. At per‐woman level, pooling of unadjusted estimates shown an inverted J‐shaped relationship between maternal BMI and CPR; pooling of adjusted estimates showed a linear association, suggesting statistical association between higher maternal BMI and lower CPR (adjusted OR [aOR] for 5‐unit increase in BMI: 0.96, 95%CI: 0.94–0.98). At per‐cycle level, linear dose–response relationship was found between maternal BMI and CPR (crude relative risk, RR, [cRR] for 5‐unit increase in BMI 0.97, 0.96–0.98; aOR 0.96, 0.94–0.99). Linear dose–response relationship was established between maternal BMI and the outcomes of MR or LBR (higher BMI associated with higher MR [cRR 1.15, 1.08–1.22] and lower LBR [cRR 0.91, 0.88–0.94] at per‐woman level). Sensitivity analyses showed no significant changes. In conclusion, there is dose–response relationship between maternal BMI and pregnancy outcomes following assisted reproductive technology. Higher BMI values may suggest suboptimal pregnancy outcomes.