Fetal hypoxia and maternal obesity – A systematic review.

Abstract

Background

This systematic review aims to evaluate the association between maternal obesity and fetal hypoxia and to synthesize existing evidence on the pathophysiological mechanisms linking these two conditions.

Materials and methods

Original research articles published between 2020 and 2024 were included. Eligibility criteria comprised case studies and scientific literature specifically addressing fetal hypoxia and maternal obesity, while irrelevant studies were excluded. Databases searched included PubMed, Lilacs, Embase, Scopus, and Web of Science (last search: April 2026). A total of 68 records were identified, of which 5 studies met the inclusion criteria. Data items extracted included first author, year, country, study type, and outcomes. Data synthesis was performed narratively following PRISMA guidelines. Study quality was assessed using the STROBE checklist.

Results

Following PRISMA guidelines, the five included studies consistently demonstrated that maternal obesity is associated with signs of chronic fetal hypoxia, altered placental phenotype, increased oxidative metabolism, and disruptions in maternal-placental-fetal immunology. Key findings include increased hypoxia-sensitive parameters in fetal blood, elevated inflammatory markers, and reduced placental vascular branching in obese pregnancies.

Conclusion

Maternal obesity is becoming more common, particularly in younger age groups, at a startling rate that has serious consequences for public health. In terms of morbidity and resources, the obesity epidemic is quite concerning. It has been calculated that the cost of obesity is five times higher than that of non-obese women.

 Need for future research.

Future research should focus on identifying specific adipokine, insulin, and angiogenic factor combinations that lead to different neonatal phenotypes, as well as developing targeted interventions to prevent fetal hypoxia in obese pregnancies.