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Peer-reviewedCC BY-NC-NDArchives of gynecology and obstetrics

The impact of obesity and overweight on maternal and fetal health with conservative preconception interventions: a structured narrative review.

  • Szczerba Mateusz1
  • Hejnosz Aleksandra1
  • Falecka Katarzyna1
  • Urban Aleksandra2
  • Kacperczyk-Bartnik Joanna3
  • Romejko-Wolniewicz Ewa3
  1. 1Students Scientific Group, 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
  2. 22nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland. [email protected].
  3. 32nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
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Abstract

Purpose

Overweight and obesity before pregnancy are associated with adverse maternal, pregnancy-related, and longer-term health outcomes. This review aimed to summarize recent evidence on preconception overweight and obesity and to synthesize findings on conservative preconception or interpregnancy interventions, including lifestyle, dietary, behavioral, weight-management, and supplementation-based strategies.Methods

A structured narrative review with a predefined database search was conducted. PubMed and Embase were searched for studies published between January 2019 and December 2023 using the search string (("obesity" OR "overweight") AND "preconception"). Due to heterogeneity in study design, populations, interventions, comparators, outcomes, and follow-up durations, findings were synthesized narratively rather than quantitatively. Thirteen studies were included: 11 intervention studies and 2 observational cohort studies retained as contextual evidence.Results

Observational evidence associated higher preconception BMI with adverse pregnancy-related outcomes, including labor induction, cesarean delivery, preterm birth, neonatal care admission, stillbirth, and post-delivery dysglycemia. Conservative interventions showed heterogeneous effects. Preconception weight loss was associated with selected fertility-related and glucose-related benefits in some studies, including shorter time to pregnancy after a very-low-energy diet intervention and lower odds of recurrent gestational diabetes mellitus when meaningful weight loss was achieved. Supplementation-based interventions showed inconsistent findings across BMI subgroups. Safety-related outcomes varied between studies, and long-term follow-up suggested that sustained benefits may depend on successful weight loss and maintenance of behavioral change.Conclusions

Conservative preconception interventions may provide selected benefits for women with overweight or obesity, particularly when clinically meaningful weight loss is achieved. However, current evidence remains heterogeneous and does not define a single optimal intervention model, timing, or universal weight-loss target.

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Cite

BibTeXRIS
BibTeX
@article{mateusz2026impact,
  title = {{The impact of obesity and overweight on maternal and fetal health with conservative preconception interventions: a structured narrative review.}},
  author = {Szczerba Mateusz and Hejnosz Aleksandra and Falecka Katarzyna and Urban Aleksandra and Kacperczyk-Bartnik Joanna and Romejko-Wolniewicz Ewa},
  journal = {Archives of gynecology and obstetrics},
  year = {2026},
  month = jul,
  doi = {10.1007/s00404-026-08527-8},
  url = {https://europepmc.org/article/MED/42894025},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - The impact of obesity and overweight on maternal and fetal health with conservative preconception interventions: a structured narrative review.
AU  - Szczerba Mateusz
AU  - Hejnosz Aleksandra
AU  - Falecka Katarzyna
AU  - Urban Aleksandra
AU  - Kacperczyk-Bartnik Joanna
AU  - Romejko-Wolniewicz Ewa
PY  - 2026
DA  - 2026/07/01
JO  - Archives of gynecology and obstetrics
DO  - 10.1007/s00404-026-08527-8
UR  - https://europepmc.org/article/MED/42894025
AB  - Purpose  Overweight and obesity before pregnancy are associated with adverse maternal, pregnancy-related, and longer-term health outcomes. This review aimed to summarize recent evidence on preconception overweight and obesity and to synthesize findings on conservative preconception or interpregnancy interventions, including lifestyle, dietary, behavioral, weight-management, and supplementation-based strategies.Methods  A structured narrative review with a predefined database search was conducted. PubMed and Embase were searched for studies published between January 2019 and December 2023 using the search string (("obesity" OR "overweight") AND "preconception"). Due to heterogeneity in study design, populations, interventions, comparators, outcomes, and follow-up durations, findings were synthesized narratively rather than quantitatively. Thirteen studies were included: 11 intervention studies and 2 observational cohort studies retained as contextual evidence.Results  Observational evidence associated higher preconception BMI with adverse pregnancy-related outcomes, including labor induction, cesarean delivery, preterm birth, neonatal care admission, stillbirth, and post-delivery dysglycemia. Conservative interventions showed heterogeneous effects. Preconception weight loss was associated with selected fertility-related and glucose-related benefits in some studies, including shorter time to pregnancy after a very-low-energy diet intervention and lower odds of recurrent gestational diabetes mellitus when meaningful weight loss was achieved. Supplementation-based interventions showed inconsistent findings across BMI subgroups. Safety-related outcomes varied between studies, and long-term follow-up suggested that sustained benefits may depend on successful weight loss and maintenance of behavioral change.Conclusions  Conservative preconception interventions may provide selected benefits for women with overweight or obesity, particularly when clinically meaningful weight loss is achieved. However, current evidence remains heterogeneous and does not define a single optimal intervention model, timing, or universal weight-loss target.
SN  - 0932-0067
SN  - 1432-0711
ER  -