The Effect of Methods Used in the Management of Obesity in Infertile Obese Women on Obstetric Outcomes: A Systematic Review and Meta-Analysis

Abstract

Aim: This study was conducted to determine the effects of the methods used in the management of obesity in infertile obese women on obstetric outcomes.
Method: The study was conducted in a systematic review and meta-analysis design. Searches were made between February and March 2021, using the word groups obesity* AND infertility* AND weight control*AND weight reduction* from PubMed, National Thesis Centre, DergiPark, MEDLINE, the Cochrane Library and, EBSCO search engines. The methodological quality of the studies was evaluated with the Critical Evaluation Checklists developed by the Joanna Briggs Institute. Data were synthesized by meta-analysis methods.
Results: For this study, the results of 19 studies published in 2010-2021 were compiled. The total sample size of the studies is 3253. In the meta-analysis results, pregnancy occurs in the intervention group was 2.12 (OR: 2.12, p= 0.002), spontaneous pregnancy was 2.19 (OR: 2.19, p<0.001), live birth rate was 1.5 (OR: 1.50, p=0.04), and the probability of developing abortion was 1.58 (OR: 1.58, p=0.01) times higher. The combined results of the studies showed that the methods used resulted in a statistically significant reduction in body mass index (p=0.0003), obstetric cost per woman (p=0.0007) and, birth weight (p=0.04). In addition don’t affect the results of obstetric complications.
Conclusion: In this study, it was revealed that the methods used in weight management in obese infertile women increase the rate of pregnancy formation, live birth, spontaneous pregnancy, and abortion, do not affect the results of obstetric complications, women and infant health.

Keywords

• Obesity
• Infertility
• Pregnancy
• Diet
• Exercise
• Weight loss

İnfertil Obez Kadınlarda Obezitenin Yönetiminde Kullanılan Yöntemlerin Obstetrik Sonuçlara Etkisi: Sistematik Derleme ve Meta-Analiz

Abstract

Amaç: Bu çalışma, infertil obez kadınlarda obezitenin yönetiminde kullanılan yöntemlerin obstetrik sonuçlara etkisinin belirlemesi amacı ile yapılmıştır.
Yöntem: Çalışma sistematik derlemede ve meta-analiz deseninde yapılmıştır. Taramalar Şubat-Mart 2021 tarihleri arasında, obesity* AND infertility* AND weight control*AND weight reduction* kelime grupları ile PubMed, Ulusal Tez Merkezi, DergiPark, MEDLINE, the Cochrane Library ve EBSCO arama motorlarından yapılmıştır. Araştırmaların metodolojik kalitesi Joanna Briggs Institute tarafından geliştirilen deneysel, yarı deneysel ve kesitsel çalışmalar için Kritik Değerlendirme Kontrol Listeleri ile değerlendirilmiştir. Veriler meta-analiz yöntemleri ile sentez edilmiştir.
Bulgular: Çalışmaya 2010–2021 yıllarında yayımlanmış 19 araştırma dâhil edilmiştir. Araştırmaların toplam örneklem hacmi 3253’tür. Meta-analiz sonuçlarında, müdahale grubunda gebelik oluşumunun 2.12 (OR: 2.12, p= 0.002), spontan gebeliğin 2.19 (OR: 2.19, p<0.001), canlı doğum oranının 1,5 (OR: 1.50, p=0.04) ve abortus gelişme olasılığının 1.58 (OR: 1.58, p=0.01) kat daha fazla olduğu bulunmuştur. Çalışmaların birleştirilmiş sonuçları, kullanılan yöntemlerin, beden kitle indeksi (p=0.0003), kadın başına düşen obstetrik maliyet (p=0.0007) ve doğum ağırlığında (p=0.04) istatistiksel olarak anlamlı azalmaya neden olduğunu ve yardımlı gebelik, çoğul gebelik, ektopik gebelik, sezaryen doğum, preterm doğum, laserasyon, doğum sonu kanama, preeklemsi, gestasyonel diyabet, gestasyonel hipertansiyon, HELLP sendromu, APGAR<7 ve konjenital anomali üzerine etkili olmadığını göstermiştir.
Sonuç: Bu çalışmada, obez infertil kadınlarda kilo yönetiminde kullanılan yöntemlerin, kilo kaybı, gebelik oluşumu, canlı doğum, spontan gebelik ve abortus oranını arttırdığı, obstetrik komplikasyonlar, kadın ve bebek sağlığı ile ilgili sonuçları etkilemediği, obstetrik maliyeti düşürdüğü sonuçları açığa çıkarılmıştır.

Keywords

• obezite
• infertilite
• gebelik
• diyet
• egzersiz
• kilo kaybı

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