La obesidad materna y la macrosomía fetal: una revisión sistemática
Maternal obesity and fetal macrosomia: a systematic reviewBarra lateral del artículo
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Introducción: La obesidad materna, que implica un índice de masa corporal (IMC) mayor a 30 kg/m², se asocia con complicaciones obstétricas y neonatales, entre las que destaca la macrosomía fetal (peso al nacer >4000 g). Esta condición incrementa riesgos como diabetes gestacional, parto por cesárea y obesidad infantil, y perpetúa un ciclo intergeneracional de enfermedades metabólicas. Este estudio busca sintetizar la evidencia científica sobre esta relación. Metodología: Se realizó una revisión sistemática siguiendo la guía Prisma 2020 y utilizando las bases de datos Springerlink, Scopus y PubMed (2019-2025). Se incluyeron artículos originales en inglés y español de acceso abierto, y se excluyeron tesis y revisiones no pares. Las palabras clave fueron “malnutrición materna”, “obesidad materna” y “macrosomía”, adaptadas a cada motor de búsqueda. Resultados: De 29 artículos analizados, se identificó que el IMC pregestacional elevado y la ganancia de peso gestacional excesiva son predictores independientes de macrosomía. Factores como edad materna avanzada, diabetes gestacional, alteraciones lipídicas y sedentarismo potencian el riesgo, mientras que el control prenatal y el ejercicio lo reducen. Conclusión: La obesidad materna y el aumento de peso gestacional son determinantes críticos de macrosomía fetal, con impacto en la salud perinatal. Se recomienda intervenciones tempranas, como seguimiento metabólico riguroso y promoción de hábitos saludables para mitigar riesgos.
Introduction: Maternal obesity, defined as a body mass index (BMI) greater than 30 kg/m², is associated with obstetric and neonatal complications, notably fetal macrosomia (birth weight >4000 g). This condition increases risks such as gestational diabetes, cesarean delivery, and childhood obesity, perpetuating an intergenerational cycle of metabolic diseases. This study aims to synthesize the scientific evidence on this relationship. Methodology: A systematic review was conducted following the PRISMA 2020 guidelines, using the Springerlink, Scopus, and PubMed databases (2019–2025). Original open-access articles in English/Spanish were included, excluding theses and non-peer-reviewed reviews. The keywords were maternal malnutrition, maternal obesity, and macrosomia, adapted to each search engine. Results: Of the 29 articles analyzed, high pregestational BMI and excessive gestational weight gain were identified as independent predictors of macrosomia. Factors such as advanced maternal age, gestational diabetes, lipid abnormalities, and a sedentary lifestyle increase the risk, while prenatal care and exercise reduce it. Conclusion: Maternal obesity and gestational weight gain are critical determinants of fetal macrosomia, with an impact on perinatal health. Early interventions, such as rigorous metabolic monitoring and promotion of healthy habits, are recommended to mitigate risks.
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