Abstract：
Maternal obesity and gestational diabetes mellitus (GDM) prevalence are increasing, with both conditions associated with adverse neonatal outcomes. This review aimed to determine the risk of adverse outcomes in women with obesity and GDM, compared with women with obesity alone. A systematic search identified 28 eligible articles. Meta-analysis was conducted using a random effects model, to generate pooled estimates (odds ratios, OR, or mean difference, MD). Compared with normal-weight controls, women with obesity had increased risks of large for gestational age (LGA, OR 1.98, 95% CI: 1.56, 2.52) and macrosomia (OR 2.93, 95% CI: 1.71, 5.03); the latter\'s risk almost double in women with obesity than GDM. Birth weight (MD 113 g, 95% CI: 69, 156) and shoulder dystocia (OR 1.23, 95% CI: 0.85, 1.78) risk was also higher. GDM significantly amplified neonatal risk in women with obesity, with a three- to four-fold risk of LGA (OR 3.22, 95% CI: 2.17, 4.79) and macrosomia (OR 3.71, 95% CI: 2.76, 4.98), as well as higher birth weights (MD 176 g, 95% CI: 89, 263), preterm delivery (OR 1.49, 95% CI: 1.25, 1.77), and shoulder dystocia (OR 1.99, 95% CI: 1.31, 3.03), when compared with normal-weight controls. Our findings demonstrate that maternal obesity increases serious neonatal adverse risk, magnified by the presence of GDM. Effective strategies are needed to safeguard against neonatal complications associated with maternal obesity, regardless of GDM status.
摘要：
孕妇肥胖和妊娠期糖尿病（GDM）的患病率正在增加，这两种情况都与不良新生儿结局相关。这篇综述旨在确定肥胖和GDM女性不良结局的风险。与单纯肥胖的女性相比。系统搜索确定了28篇合格文章。Meta分析采用随机效应模型，生成汇总估计(赔率比，OR,或平均差异，MD）。与正常体重对照组相比，肥胖女性孕龄较大的风险增加(LGA，OR1.98，95％CI：1.56，2.52）和巨大儿（OR2.93，95％CI：1.71，5.03）；肥胖女性的后者风险几乎是GDM的两倍。出生体重（MD113g，95%CI：69，156）和肩难产（OR1.23，95%CI：0.85，1.78）的风险也较高。GDM显著放大肥胖女性的新生儿风险,LGA（OR3.22，95％CI：2.17，4.79）和巨大儿（OR3.71，95％CI：2.76，4.98）的三至四倍风险，以及较高的出生体重(MD176克，95%CI：89，263），早产（OR1.49，95%CI：1.25，1.77），肩难产（OR1.99，95%CI：1.31，3.03），与正常体重对照组相比。我们的研究结果表明，母亲肥胖会增加严重的新生儿不良风险，被GDM的存在放大。需要有效的策略来预防与母亲肥胖相关的新生儿并发症，无论GDM状态如何。
