Tesis

The Association of Maternal Obesity on Low Birth Weight: A Systematic Review and Meta-Analysis = Hubungan antara Obesitas pada Kehamilan terhadap Risiko Kejadian Berat Badan Lahir Rendah: Sistematik Review dan MetaAnalisis.

Introduction: Obesity during pregnancy increases the risk of various adverse outcomes, including low birth weight (LBW) which is indicated by condition small for gestational age (SGA) infants, and preterm birth (PTB). PTB can be further categorised into medically indicated PTB, spontaneous PTB, and preterm birth following premature rupture of membranes (PROM). Gestational weight gain (GWG) plays a pivotal role in influencing these risks, potentially exacerbating or mitigating the impact of maternal obesity on pregnancy outcomes. This meta-analysis investigates the association between maternal obesity and LBW, with a specific focus on SGA and PTB, as well as the influence of GWG in obese populations on LBW outcomes. Methods: This systematic review and meta-analysis was developed in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, this study employs a systematic review and meta-analysis design. A comprehensive search was conducted in PubMed, Scopus, EBSCOhost, and Taylor & Francis databases. Observational studies were included based on predefined eligibility criteria, including cohort, case-control, and cross-sectional designs. Quality was assessed using the Newcastle–Ottawa scale. Maternal obesity was defined as pre-pregnancy body mass index (BMI) ≥ 25 kg/m². Meta-analyses were performed using Review Manager 5.4, pooling effect sizes and calculating adjusted odds ratios (ORs) from included studies. Results: Over 8364 potentially relevant articles and 50 studies were included in the meta-analysis. Pooled analysis revealed significant associations between pre-pregnancy BMI ≥ 25 kg/m² and SGA (OR 1.20 (95% CI 1.09, 1.32), PTB (OR 1.05, 95% CI 1.03–1.07), LBW (OR 1.16, 95% CI 1.05–1.29), and PPROM (OR 2.01, 95% CI (1.15, 3.49). Maternal obesity was also linked to an elevated risk of medically indicated PTB. Additionally, low GWG or weight loss in obese mothers was associated with an increased risk of LBW and SGA. Conclusion: Maternal obesity might increase the risk of adverse pregnancy outcomes, including LBW, PTB, and SGA.
Keywords: Low Birth Weight, Maternal Obesity, Preterm Birth, Small for Gestational Age


Pendahuluan: Obesitas selama kehamilan meningkatkan risiko berbagai dampak buruk, termasuk berat badan lahir rendah (BBLR) yang ditunjukkan oleh kondisi bayi kecil untuk usia kehamilan (SGA) dan kelahiran prematur (PTB). PTB dapat dikategorikan lebih lanjut menjadi PTB yang ditentukan secara medis, PTB spontan, dan kelahiran prematur akibat pecahnya selaput ketuban dini (PPROM). Peningkatan berat badan selama kehamilan (GWG) memiliki peran penting dalam memengaruhi risikorisiko ini, baik dengan memperburuk maupun mengurangi dampak obesitas ibu terhadap hasil kehamilan. Meta-analisis ini bertujuan untuk melihat hubungan antara obesitas ibu dan BBLR, dengan fokus khusus pada SGA dan PTB, serta pengaruh GWG pada populasi ibu obesitas terhadap risiko BBLR. Metode: Tinjauan sistematis dan meta-analisis ini disusun sesuai dengan pedoman Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Pencarian komprehensif dilakukan pada basis data PubMed, Scopus, EBSCOhost, dan Taylor & Francis. Studi observasional, termasuk desain kohort, kasus-kontrol, dan potong lintang, dimasukkan berdasarkan kriteria kelayakan yang telah ditentukan. Kualitas studi dinilai menggunakan skala Newcastle–Ottawa. Obesitas didefinisikan sebagai indeks massa tubuh (IMT) sebelum kehamilan ≥ 25 kg/m². Meta-analisis dilakukan menggunakan Review Manager 5.4 dengan menggabungkan effect size dan menghitung rasio odds (OR) yang telah disesuaikan dari studi yang memenuhi kriteria. Hasil: Dari 8.364 artikel yang berpotensi dan relevan, 50 studi memenuhi kriteria untuk meta-analisis. Analisis menunjukkan hubungan signifikan antara IMT sebelum kehamilan ≥ 25 kg/m² dengan SGA (OR 1.20 (95% CI 1.09, 1.32), PTB (OR 1,05; 95% CI 1,03–1,07), BBLR (OR 1,16; 95% CI 1,05–1,29), dan PPROM (2.01, 95% CI (1.15, 3.49). Obesitas pada kehamilan juga terkait dengan peningkatan risiko PTB yang diindikasi secara medis. Selain itu, GWG yang rendah atau penurunan berat badan pada ibu obesitas meningkatkan risiko BBLR dan SGA. Kesimpulan: Obesitas pada kehamilan memiliki asosiasi dan dapat meningkatkan risiko BBLR, PTB, dan SGA.
Kata Kunci: Berat Badan Lahir Rendah, Kelahiran Prematur, Obesitas Kehamilan, Small for Gestational Age