|
| Study | Representativeness of the exposed cohort | Source of nonexposed cohort | Ascertainment of exposure (obesity) | Comparability of cohorts | Adequacy of follow-up | Overall rating |
|
|
Hoff et al., 2009 [42] | Moderate
Outcome of second pregnancy in women who were overweight in their first pregnancy | High
Same population as exposed cohort | Low
No information | Low
Comparable for parity and race
Not comparable for age and socioeconomic status
No information on diabetes or hypertension | High
Retrospective cohort, 100% “follow-up” | Low |
|
| Salihu et al., 2009 [43] | High
State-wide registry used to validate US national datasets | High
Same population as exposed cohort | Moderate
Self-reported prepregnancy weight, measured height | Low
No comparable variables
Not comparable for age, parity, diabetes, hypertension, or race
No information on socioeconomic status | High
Retrospective cohort, 100% “follow-up” | Moderate |
|
| Crane et al., 2009 [44] | High
Provincial perinatal database | High
Same population as exposed cohort | Low
Self-reported prepregnancy weight and height | Low
Comparable for age
Not comparable for parity, diabetes, hypertension
No information on socioeconomic status or race | High
Prospective cohort, 100% “follow-up” | Moderate |
|
| Leung et al., 2008 [45] | Low
Not enough information to determine | High
Same population as exposed cohort | Low
BMI obtained from weight and height at antenatal booking—unclear whether self-report or measured | Low
Comparable for age and race
Not comparable for parity, presence of diabetes, presence of hypertension
No information on socioeconomic status | High
Prospective cohort, 100% “follow-up” | Low |
|
Nohr et al.,
2008 [46, 47] | High
Truly representative of the average obese pregnant woman in Denmark | High
Same population as exposed cohort | Low
Self-reported prepregnancy weight and height | Low
Not comparable for age, parity, presence of diabetes, presence of hypertension, socioeconomic status
No information on race | Low
~30% of women were excluded because they did not participate in the second interview, no description given | Moderate |
|
|
Khashan and Kenny 2009 [48] | High
Truly representative of the average obese pregnant woman in Manchester | High
Same population as exposed cohort | High
Measured height and first antenatal visit (around 16 weeks) | Moderate
Comparable for age and socioeconomic status
Not comparable for parity or race
No information on presence of diabetes or hypertension | High
Prospective cohort, 100% “follow-up” | High |
|
| Bhattacharya et al., 2007 [24] | High
Truly representative of the average obese pregnant woman in Aberdeen and district | High
Same population as exposed cohort | High
Measured height and first antenatal visit (around 10 weeks) | Low
Comparable for parity
Not comparable for maternal age, presence of diabetes, presence of hypertension, socioeconomic status
No information for race | High
Prospective cohort, 100% “follow-up” | High |
|
| Getahun et al., 2007 [49] | High
Truly representative of the average obese pregnant woman in Missouri | High
Same population as exposed cohort | Low
Self-reported prepregnancy weight and height | Low
Not comparable for age, presence of diabetes, presence of hypertension or race
No information for parity or socioeconomic status | High
Retrospective cohort, 100% “follow-up” | Moderate |
|
| Sukalich et al., 2006 [50] | Low
Selected group of users—<19 years old only | High
Same population as exposed cohort | Low
Self-reported prepregnancy weight and height | Low
Comparable for presence of preexisting diabetes
Not comparable for maternal age, parity, presence of hypertension, socioeconomic status, or race
No information on multiple gestation | High
Retrospective cohort, 100% “follow-up” | Low |
|
| Jensen et al., 2003 [51] | Low
Selected group of users—women with a normal 75 g OGTT | High
Same population as exposed cohort | Low
No description of how prepregnancy BMI was obtained | Low
Comparable for presence of diabetes
Not comparable for age, parity, presence of hypertension, or race
No information for socioeconomic status or multiple gestation | High
Prospective cohort, 100% “follow-up” | Low |
|
| Stepan et al., 2006 [52] | High
Truly representative of the average obese pregnant woman in Leipzig | High
Same population as exposed cohort | Low
No description of how prepregnancy BMI was obtained | Low
Comparable for maternal age
No information for parity, presence of diabetes, presence of hypertension, socioeconomic status, or race | High
Retrospective cohort, 100% “follow-up” | Low |
|
| Athukorala et al., 2010 [53] | Low
Selected group of users—women enrolled in the Australian Collaborative Trial of Supplements with antioxidants vitamin C and vitamin E | High
Same population as exposed cohort | High
Measured height and first antenatal visit | Moderate
Comparable for age, parity, and race
Not comparable for presence of diabetes, presence of hypertension, or socioeconomic status | Information not available | High |
|
|
Narchi and Skinner 2010 [54] | High
Truly representative of the average obese pregnant woman in the UK site | High
Same population as exposed cohort | High
Measured height and first antenatal visit (8–12 weeks) | Low
Comparable for age
Not comparable for parity, presence of diabetes, presence of hypertension, or race
No information on socioeconomic status | High
Retrospective cohort, 100% “follow-up” | High |
|
| Baeten et al., 2001 [23] | High
Truly representative of the average obese pregnant woman in the state of Washington | High
Same population as exposed cohort | Low
Self-reported prepregnancy weight and height | Low
Comparable for parity
Not comparable for age, presence of diabetes, presence of hypertension, socioeconomic status, or race | High
Retrospective cohort, 100% “follow-up” | Moderate |
|
| Clausen et al., 2005 [55] | Low
Selected group of users (participants in a larger cohort study) | High
Same population as exposed cohort | Low
No description of how obesity was ascertained | Low
No information given on age, parity, presence of diabetes, presence of hypertension, socioeconomic status, or race | Low
Loss to follow-up 244/2294, 10.6% | Low |
|
| Driul et al., 2008 [56] | High
Truly representative of the average obese pregnant woman in the state of Washington | High
Same population as exposed cohort | Low
Self-reported prepregnancy weight and height | Low
No information given on age, parity, presence of diabetes, presence of hypertension, socioeconomic status, or race | High
Retrospective cohort, 100% “follow-up” | Low |
|
| Roman et al., 2007 [57] | High
Truly representative of the average obese pregnant woman on Reunion Island (consecutive cases) | High
Controls derived from the same population as cases | Low
No description of how obesity was ascertained | Moderate
Comparable for age and parity
Not comparable for presence of diabetes, presence of hypertension, or race
No information on socioeconomic status | High
Retrospectively derived cases and controls | Moderate |
|
| Sahu et al., 2007 [58] | Moderate
Somewhat representative of the average obese woman in Northern India (had to deliver on site) | High
Controls derived from the same population as cases | Low
No description of how obesity was ascertained | Moderate
Comparable for age and parity
Not comparable for presence of diabetes or presence of hypertension
No information on socioeconomic status or race | High
Retrospectively derived cohort | Low |
|
|
van Wootten and Turner 2002 [59] | Low
Selected group—patients with gestational diabetes | High
Controls derived from the same population as cases | High
Measured height and first antenatal visit (8-9 weeks) | Low
Comparable for presence of diabetes
No information for age, parity, presence of hypertension, socioeconomic status, or race | Low
14 women were missing height and weight information | Moderate |
|
Rode et al.,
2005 [33, 60] | High
Truly representative of the average obese pregnant woman in Copenhagen | High
Controls derived from the same population as cases | Low
Self-reported prepregnancy weight and height | Low
Not comparable for presence of diabetes or presence of hypertension
No information on age, parity, socioeconomic status, or race | High
Retrospective cohort, 100% “follow-up” | Moderate |
|
| Magann et al., 2011 [61] | Moderate
Somewhat representative of the average obese woman in Jackson or Portsmouth (two hospitals only, one naval) | High
Controls derived from the same population as cases | High
Measured height and first antenatal visit (all first trimester) | Low
Not comparable for age, parity, presence of diabetes, presence of hypertension, or race
No information for socioeconomic status | High
Retrospective cohort, 100% “follow-up” | Moderate |
|
| Lumme et al., 1995 [62] | High
Truly representative of the average obese pregnant woman in Northern Finland | High
Controls derived from the same population as cases | High
Measured height and first antenatal visit (all first visit) | Low
Not comparable for age, parity, presence of diabetes, or presence of hypertension
No information for socioeconomic status or race | High
Prospective cohort, 100% “follow-up” | High |
|
| Langer et al., 2005 [63] | Low
Selected group of users (women with GDM) | High
Controls derived from the same population as cases | Low
No description of how prepregnancy BMI was derived | Low
Not comparable for age or parity
No information for hypertension, socioeconomic status, race, or multiple gestation | High
Prospective cohort, 100% “follow-up” | Low |
|
| Jensen et al., 1999 [64] | Moderate
Somewhat representative of the average pregnant woman in Herning (several exclusion criteria) | High
Controls derived from the same population as cases | Low
No description of how obesity was ascertained | Low
Comparable for presence of diabetes and presence of hypertension
No information on age, parity, socioeconomic status, or race
| High
Retrospective cohort 100% “follow-up” | Low |
|
|
Mantakas and Farrell 2010 [65] | Low
Selected group of users (nulliparous women, one hospital site) | High
Controls derived from the same population as cases | Low
No description of how obesity was ascertained | Low
Not comparable for age or race
Comparable for parity
No information for presence of diabetes, presence of hypertension, or socioeconomic status | High
Retrospective cohort, 100% “follow-up” | Low |
|
|
El-Gilany and Hammad 2010 [66] | Low
Selected group of users—volunteers | High
Same population as exposed cohort | High
Measured height and first antenatal visit | Low
Comparable for socioeconomic status
Not comparable for age, parity, presence of diabetes, or presence of hypertension
No information on race | Moderate
Subjects lost to follow-up unlikely to introduce bias (<5% and description given) | Moderate |
|
| Bodnar et al., 2010 [67] | High
Truly representative of the average obese pregnant woman in Pittsburgh, PA | High
Same population as exposed cohort | Low
Self-reported prepregnancy weight and height | Low
Not comparable for age, parity, or race
No information on presence of diabetes, presence of hypertension, or socioeconomic status | High
Retrospective cohort, 100% “follow-up” | Moderate |
|
| Le Thai et al., 1992 [68] | Moderate
Case definition adequate but not independently validated, consecutive cases | High
Controls from same population as cases | Low
Self-reported prepregnancy weight and height | Low
Comparable for age
Not comparable for parity, presence of diabetes, presence of hypertension
No information for socioeconomic status or race | High
Retrospective case control study, no loss to follow-up | Moderate |
|
| Voigt et al., 2008 [69, 70] | High
Truly representative of the average obese pregnant woman in Germany | High
Same population as exposed cohort | High
Measured height and first antenatal visit | Low
Comparable for age
Not comparable for parity, presence of diabetes, or presence of hypertension
No information on socioeconomic status or race | High
Retrospective cohort, 100% “follow-up” | High |
|
| Brennand et al., 2005 [71] | High
Truly representative of the average obese pregnant Cree woman in James Bay | High
Same population as exposed cohort | High
Measured height and first antenatal visit (<14 weeks) | Low
Comparable for race
Not comparable for age, presence of diabetes, or presence of hypertension
No information on socioeconomic status or parity | Low
314 women were excluded because they did not have a recorded first weight <14 weeks (no description given) | High |
|
