The Edmonton Obesity Staging System and pregnancy outcomes in women with overweight or obesity: A secondary analysis of a randomized controlled trial

Abstract

Summary The Edmonton Obesity Staging System (EOSS) is a proposed clinical practice tool to determine obesity severity. In a secondary analysis of the Pregnancy Exercise and Research Study (PEARS) (a mobile‐health‐supported lifestyle intervention among pregnant women with body mass index [BMI] ≥25 kg/m2), we apply the EOSS and explore relationships with pregnancy outcomes. In early (14–16 weeks) and late (28 weeks) pregnancy, fasting lipids and glucose were measured, blood pressure was extracted from medical records and maternal well‐being was assessed using the WHO‐5 Well‐being Index. Pearson's correlations, chi‐square statistics and multiple logistic regression were used to identify relationships. One‐way analysis of variance was used to compare groups. Pregnant women (n = 348) were mean (SD) age 32.44 (4.39) years and median (interquartile range) BMI 28.0 (26.57, 29.88) kg/m2. Using metabolic criteria only, 81.9% and 98.9% had raised EOSS scores in early and late pregnancy. From early to late pregnancy, EOSS scores increased by 60.1%. Of these, 10.5% experienced a 2‐point increase, moving from stage 0 to stage 2. There was a potential relationship between early EOSS and large for gestational age (χ2 = 6.42, df (2), p = .04), although significance was lost when controlled for confounders (p = .223) and multiple testing. Most women with BMI ≥25 kg/m2 had raised EOSS scores, limiting the clinical utility of the tool.

Effects of Physical Activity on Quality of Life of Pregnant Women with Overweight or Obesity: A Systematic Review

“…The domains for which two of the publications were assessed with a "high risk of bias" are the "selection of reported results" domain, due to the studies representing secondary measures and not being part of the a priori power analysis [23] , and the "measurement of results" domain, due to the use of dummy variables for physical activity data when baseline values were absent [27]. The same domains also reveal "some concerns" in three clinical trials due to missing information related to the selection of the data presented [24,27] and the evaluators' knowledge of the intervention due to its direct nature [26]. On the other hand, the domains relating to the "randomization process", "deviations from the intended interventions" and "missing outcome data" present a "low risk of bias" in all six articles selected for review.…”

“…The six studies [23][24][25][26][27][28] were published between 2013 [27] and 2022 [26]. Three studies were carried out in Europe [25][26][27], and the other three took place in the United States of America [23], Australia [24] and New Zealand [28].…”

“…The six studies [23][24][25][26][27][28] were published between 2013 [27] and 2022 [26]. Three studies were carried out in Europe [25][26][27], and the other three took place in the United States of America [23], Australia [24] and New Zealand [28]. All studies used hospital infrastructures, with five of them taking place in a public setting [24][25][26][27][28] and one in a private setting [23].…”

“…In terms of inclusion criteria, all the studies included pregnant women who were overweight or obese. One of the studies [27] had a sample made up only of pregnant women with a BMI ≥ 30 kg/m 2 , another study [25] focused only on pregnant women with a BMI ≥ 28 kg/m 2 and in the remaining four studies the BMI considered was ≥25 kg/m 2 [23,24,26,28].…”

“…Four studies included pregnant women over the age of 18 [16,23,25,28], two of which set an age limit of 40 [23,28] and one of 45 [26].…”