Background: Women who experience adverse outcomes of pregnancy including preeclampsia, gestational diabetes mellitus (GDM), small for gestational age (SGA) and spontaneous preterm birth (sPTB) are known to be at increased risk of coronary artery disease (CAD) in later life. However, it is not known whether these women have pre-existing risk factors that contribute to both increased risk of adverse pregnancy outcomes and CAD. Metabolic syndrome (MetS) is a collection of CAD risk factors. We conducted a systematic review and meta-analysis to assess the risk for adverse pregnancy outcomes among women with MetS in pregnancy.
Methods: The PubMed, EMBASE, CINAHL, Web of Science and Scopus databases were searched. The review protocol is registered in PROSPERO (CRD42023460729). The risk for adverse pregnancy outcomes was measured using a fixed effects model using the JBI SUMARI software. Quality assessment was performed using the JBI critical appraisal checklist. The study selection, data extraction and data analyses were performed in accordance with the MOOSE guidelines.
Results: Seven studies met the inclusion criteria and were included in the meta-analysis, providing data on 4,446 pregnant women with metabolic syndrome and 43,095 pregnant women without metabolic syndrome. Women with MetS in pregnancy are at 2.72 (95% CI 1.80- 4.12) times increased risk of adverse pregnancy outcomes compared to women without MetS in pregnancy.
Conclusion: Screening for MetS in early pregnancy may help identify women at risk of adverse pregnancy outcomes and later life CAD.
Keywords: metabolic syndrome, prevalence, preeclampsia, gestational diabetes mellitus, small for gestational age, spontaneous preterm birth