Epidemiology of Obesity During Pregnancy in Europe: A Systematic Review

Introduction: Maternal obesity represents an urgent public health challenge with serious maternal, neonatal, and health system implications. Characterizing levels of obesity during pregnancy is necessary to guide future research, policy, and practice. This review summarizes existing data on maternal obesity prevalence across Europe. Methods: Studies published between 2009 and 2023 that reported the prevalence of obesity during pregnancy were included. The primary outcome was to measure the prevalence of obesity during pregnancy. Secondary outcomes were assessing the method and timing of BMI ascertainment. Results: In total, 99 studies were included. Over three quarters of studies (N = 76, 76.7%) collected data from Swedish, United Kingdom, or Irish populations. Height was objectively assessed in 37 studies (37.4%) and weight in 53 studies (53.5%). The median obesity prevalence was 12.5% (IQR 4.4-20.6). In a subset of studies reporting prevalence by year, obesity ranged from 2.2% (1986) to 28.3% (2007) with a significant positive association of maternal obesity over time (τ = 0.64, p < 0.001). Conclusion: This review highlights consistent increases in obesity during pregnancy among European populations with significant implications for patients and health systems.