Abstract
BACKGROUND: Obesity during pregnancy poses inter-generational health risks and places added burden on healthcare systems. Characterising levels of obesity during pregnancy is necessary to guide future research, policy and practice. METHODS: The systematic review was performed according to PRISMA guidelines. PubMed, Embase and Web of Science were searched. Studies published between 2009 and 2023 that report the prevalence of obesity during pregnancy in countries in the World Health Organization (WHO) European region were eligible. The Joanna Briggs Institute Prevalence Critical Appraisal tool was used. Two reviewers screened studies independently. A single reviewer completed data extraction and quality assessments, a second checked 20% of extractions and a third resolved disagreements. Narrative synthesis was completed. RESULTS: 100 studies reporting the prevalence of obesity during pregnancy in the WHO European region were identified. 59% from Western Europe, 36% Northern, 4% Southern and 1% Eastern. Data within the studies was collected between 1950 and 2019. 35% of studies reported national estimates, 65% regional. 39% studies had measured height and weight, 34% did not report how either were ascertained, 6% used self-report for both, 17% had self-reported height but measured weight, 4% a mixture of self-report and measurement. The smallest sample was 157 while the largest was 1,891,097. Estimated prevalence of obesity during pregnancy ranged from 2.3% (Sweden, data collected 1982-1989) to 28.3% (England, 2007). CONCLUSIONS: This review identifies variation in the prevalence of obesity during pregnancy in the WHO European region. This may reflect diverse sociocultural contexts, different methodological approaches and temporal trends. There was limited evidence available for Southern and Eastern Europe. KEY MESSAGES: • There are high levels of obesity during pregnancy within the WHO European region. • Enhanced primary prevention and resourcing of obstetric services is needed.