Association between maternal overweight or obesity and cerebral palsy in children: A meta-analysis

CONTEXT: There is no consensus regarding the association between maternal obesity or overweight and cerebral palsy (CP) in children. OBJECTIVES: To investigate whether maternal obesity or overweight is associated with CP and identify the factors that explain the differences in the study results. DATA SOURCES: We conducted a meta-analysis of studies published in English with titles or abstracts that discussed the relationships between maternal obesity or overweight and CP before August 23, 2017, using Ovid Medline, EMBASE and Web of Science. STUDY SELECTION: Of 2699 initially identified studies, 8 studies that addressed the association between maternal obesity and CP met our final inclusion criteria. DATA EXTRACTION: Information from the individual studies was abstracted using standardized forms by 2 independent observers who were blinded to the authors’ names and journal titles. DATA SYNTHESIS: According to a random effects model, maternal overweight was significantly associated with CP in offspring [RR = 1.29 (95% CI, 1.04–1.60), heterogeneity (I(2) = 45.5%, P = 0.103)]; maternal obesity was significantly associated with CP in offspring [RR = 1.45 (95% CI, 1.25–1.69), heterogeneity (I(2) = 24.1%, P = 0.253)]; and maternal obesity III was significantly associated with CP in offspring [RR = 2.25 (95% CI, 1.82–2.79), heterogeneity (I(2) = 0%, P = 0.589)]. However, maternal underweight was not significantly associated with CP in offspring [RR = 1.11 (95% CI, 0.88–1.38), low heterogeneity (I(2) = 0%, P = 0.435)]. Factors that explained the differences in the meta-analysis results included study design, study location, and whether individual studies adjusted for potential confounders. CONCLUSION: This study suggests that maternal obesity and overweight increase the risk of CP in offspring. Further studies are required to confirm these results and determine the influence of variables across studies.