Studies investigating the association between maternal adiposity and risk of pre-eclampsia showed contradictory results. Therefore, we performed a meta-analysis of prospective cohort studies to estimate the effect of maternal adiposity on pre-eclampsia. We reviewed 1,286 abstracts and finally included 29 prospective cohort studies with 1,980,761 participants and 67,075 pre-eclampsia events. We pooled data with a random-effects model, and obtained risk estimates for five predetermined bodyweight groups: low, normal-weight (reference), overweight, obese and severely obese. In the cohort studies that unadjusted for pre-eclampsia risk factors, the pooled unadjusted relative risks (RR) with 95% confidence intervals (95%CI) for pre-eclampsia of overweight, obese and severely obese women were 1.58 (95% CI 1.44-1.72, P < 0.001), 2.68 (95% CI 2.39-3.01, P < 0.001) and 3.12 (95% CI 2.24-4.36, P < 0.001), respectively. In those cohorts that adjusted for pre-eclampsia risk factors, the pooled unadjusted RRs for pre-eclampsia of overweight, obese and severely obese women were 1.70 (95% CI 1.60-1.81, P < 0.001), 2.93 (95% CI 2.58-3.33, P < 0.001) and 4.14 (95% CI 3.61-4.75, P < 0.001), respectively. Sensitivity analysis showed maternal adiposity was associated with increased risk of pre-eclampsia in both nulliparous and multiparas women. In conclusion, overweight or obese pregnant women have a substantially increased risk of pre-eclampsia, and maternal adiposity is an independent risk factor of pre-eclampsia.

Many studies have investigated the association between stroke and hip fracture risk, but the precise association was still unclear due to insufficient statistical power in single studies with relatively small sample size. Thus, we firstly conducted a meta-analysis of all published studies to precisely estimate the relationship of stroke with hip fracture risk. The strength for this relationship was weighed by pooled relative risks (RRs) with 95 % confidence intervals (95 % CIs) after adjustment for confounding variables. Stratified analyses by study design and ethnicity and sensitivity analysis were also performed. Two investigators independently performed a comprehensive literature search in databases of PubMed, Embase, and Wanfang for eligible articles. A Bayesian meta-analysis was also performed to get a more precise assessment of the relationship. Eleven relevant studies from 10 publications were finally included into our meta-analysis according to the inclusion criteria. Overall, stroke significantly and independently increased the risk of hip fracture (RR = 2.06, 95 % CI 1.68-2.52, P < 0.001). Bayesian meta-analysis showed that stroke was also associated with an over two-fold increased risk of hip fracture (RR = 2.11, 95 % CI 1.62-2.75). In stratified analysis, stroke could increase the risk of hip fracture in Caucasians (RR = 2.36, 95 % CI 1.83-3.05, P < 0.001). These data support the notion that stroke is an independent risk factor for hip fracture, and patients with stroke have a two-fold increased risk of hip fracture than those without stroke.