Maternal obesity and stillbirth.

The current obesity epidemic appears to contribute significantly to adverse fetal outcomes, and in this work we compile up-to-date evidence for the link between maternal obesity and risk of stillbirth. The review revealed a preponderance of evidence showing that the risk of stillbirth is increased among obese mothers with amplified risk estimates as the severity of obesity increases. Changes in interpregnancy body mass index (BMI) influence subsequent fetal survival and obese women that normalize their BMI values experience enhanced fetal survival in future pregnancies. The elevated risk of stillbirth among obese mothers affect all gestations regardless of fetal number, with the most profound risk (4-fold increase) noted among triplet gestations. The literature has predominantly reported a strong association between maternal prepregnancy obesity and stillbirth. The considerable magnitude of association, consistency of positive results for the association between maternal obesity and stillbirth, the establishment of temporality between maternal obesity and stillbirth, the incremental elevation in risk with ascending BMI values, as well as the improvement in fetal survival with decrease in interpregnancy BMI among obese mothers strongly provide sufficient evidence that the relationship between maternal obesity and stillbirth may be causal.