The effect of weight loss interventions for obesity on fertility and pregnancy outcomes: A systematic review and meta-analysis.

Autor: Boyle BR; Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK., Ablett AD; Trauma and Orthopaedic Department, University of Edinburgh, Edinburgh, Scotland, UK., Ochi C; Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK., Hudson J; Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK., Watson L; Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK., Rauh D; Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK., Avenell A; Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2023 May; Vol. 161 (2), pp. 335-342. Date of Electronic Publication: 2022 Dec 09.
DOI: 10.1002/ijgo.14597
Abstrakt: Background: Weight loss could improve fertility, perhaps by reducing insulin resistance.
Objectives: To assess the effect of weight loss interventions on fertility in women with obesity not recruited because of known infertility.
Search Strategy: Three databases during 1966-2020, trial registry.
Selection Criteria: Randomized controlled trials (RCTs) with a follow-up of 1 year or more, with a mean cohort BMI of 30 kg/m 2 or above.
Data Collection and Analysis: A systematic review and meta-analysis was conducted. The primary outcome was pregnancy. The secondary outcome was weight change.
Main Results: A total of 27 RCTs (5938 women) were included. Weight loss interventions showed no statistically significant increase in pregnancies compared to control interventions (24 trials, 97 women with pregnancy; risk ratio [RR] 1.43, 95% confidence interval [CI] 0.91-2.23); weight change (mean difference [MD] -2.36 kg, 21 trials, 95% CI -3.17 to -1.55). Compared with low-fat diets, very-low-carbohydrate diets showed no statistically significant effect on women with pregnancy (three trials, 14 women with pregnancy; RR 1.37, 95% CI 0.49-3.84) or weight change (MD -0.32 kg, 95% CI -3.84 to 3.21).
Conclusions: Diet-based weight loss interventions for women with obesity not recruited because of infertility were effective at producing long-term weight loss. The effects on fertility were not statistically significant, but few trials provided data. Weight loss trials should routinely collect fertility outcomes.
Systematic Review Registration: PROSPERO CRD42017078819.
(© 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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