Maternal Obesity as a Risk Factor for Pregnancy-Related Metabolic Disorders and Neonatal Adversities: A Meta-Analysis of Randomized Controlled Trials

Background: Maternal obesity (BMI ≥30 kg/m²) increases risks of GDM, hypertensive disorders, preeclampsia, and neonatal complications. This meta-analysis evaluates intervention effectiveness in reducing these risks. Objective: To assess the relationship between maternal obesity and adverse outcomes, including metabolic disorders and neonatal adversities, and to evaluate the efficacy of lifestyle and medical interventions in mitigating these risks. Methods: A systematic search of PubMed, EMBASE, and Cochrane Library databases identified nine studies involving 2,700 participants. Studies included were RCTs or prospective cohort studies focusing on obese or overweight pregnant women and reporting outcomes such as GDM, preeclampsia, pregnancy weight gain, and neonatal health. Data were extracted independently, and pooled odds ratios (Ors) or weighted mean differences (WMDs) were calculated using random-effects models. Subgroup and sensitivity analyses assessed outcome variations based on intervention types, maternal BMI categories, and other factors. Results: Maternal obesity was significantly associated with adverse outcomes. For pregnancy weight gain, dietary and exercise interventions showed a pooled effect size of 0.75 (95% CI: 0.60–0.90), with low heterogeneity (I² = 20%). GDM management reduced adverse fetal growth outcomes (0.85, 95% CI: 0.70–1.00; I² = 25%). Neonatal outcomes, including preterm birth and NICU admissions, improved with a pooled effect size 1.20 (95% CI: 1.05–1.35), with moderate heterogeneity (I² = 15%). Subgroup analyses revealed intervention-specific benefits, such as supervised exercise improving maternal weight outcomes (0.88, 95% CI: 0.78–0.98; I² = 15%). Conclusion: Maternal obesity raises pregnancy-related risks, but dietary changes and exercise help. Integrating effective interventions into prenatal care is crucial for better outcomes.