BACKGROUND We systematically reviewed and chronicled exposures and outcomes measured in the maternal and birth cohort studies in the Gulf Cooperation Council (GCC) countries and quantitatively summarized the weighted effect estimates between maternal obesity and (1) cesarean section (CS) and (2) fetal macrosomia. METHODS We searched MEDLINE-PubMed, Embase, Cochrane Library, Scopus, and Web of Science electronic databases up to 30 June 2019. We considered all maternal and birth cohort studies conducted in the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE)). We categorized cohort studies on the basis of the exposure(s) (anthropometric, environmental, medical, maternal/reproductive, perinatal, or socioeconomic) and outcome(s) (maternal or birth) being measured. Adjusted weighted effect estimates, in the form of relative risks, between maternal obesity and CS and fetal macrosomia were generated using a random-effects model. RESULTS Of 3502 citations, 81 published cohort studies were included. One cohort study was in Bahrain, eight in Kuwait, seven in Qatar, six in Oman, 52 in Saudi Arabia, and seven in the UAE. Majority of the exposures studied were maternal/reproductive (65.2%) or medical (39.5%). Birth and maternal outcomes were reported in 82.7% and in 74.1% of the cohort studies, respectively. In Saudi Arabia, babies born to obese women were at a higher risk of macrosomia (adjusted relative risk (aRR), 1.15; 95% confidence interval (CI), 1.10-1.20; I2 = 50%) or cesarean section (aRR, 1.21; 95% CI, 1.15-1.26; I2 = 62.0%). Several cohort studies were only descriptive without reporting the magnitude of the effect estimate between the assessed exposures and outcomes. CONCLUSIONS Cohort studies in the GCC have predominantly focused on reproductive and medical exposures. Obese pregnant women are at an increased risk of undergoing CS delivery or macrosomic births. Longer-term studies that explore a wider range of environmental and biological exposures and outcomes relevant to the GCC region are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017068910.

中文翻译：

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海湾合作委员会国家的产妇和出生队列研究：系统的回顾和荟萃分析。

背景我们在海湾合作委员会（GCC）国家中，系统地回顾和记录了在孕产妇和出生队列研究中测得的暴露量和结局，并定量总结了孕产妇肥胖与（1）剖宫产（CS）和（2）胎儿之间的加权效应估计巨大的。方法我们搜索了截至2019年6月30日的MEDLINE-PubMed，Embase，Cochrane图书馆，Scopus和Web of Science电子数据库。我们考虑了在六个GCC国家（巴林，科威特，阿曼，卡塔尔，沙特阿拉伯）进行的所有产妇和出生队列研究阿拉伯和阿拉伯联合酋长国（UAE））。我们根据暴露量（人体测量，环境，医学，孕产/生殖，围产期或社会经济）和结果（孕产或出生）对队列研究进行了分类。调整后的加权效应估计，以相对风险的形式，使用随机效应模型生成了孕妇肥胖与CS和胎儿巨大儿之间的关系。结果在3502次引用中，包括81项已发表的队列研究。一项队列研究在巴林，八项在科威特，七项在卡塔尔，六项在阿曼，52项在沙特阿拉伯，七项在阿联酋。研究的大多数接触是孕妇/生殖器（65.2％）或医疗（39.5％）。队列研究的出生率和产妇结局分别为82.7％和74.1％。在沙特阿拉伯，肥胖妇女出生的婴儿发生巨大儿的风险较高（调整后相对危险度（aRR）为1.15； 95％置信区间（CI）为1.10-1.20； I2 = 50％）或剖宫产（aRR为1.21） ； 95％CI，1.15-1.26； I2 = 62.0％）。几项队列研究仅是描述性的，没有报告所评估的暴露与结局之间的影响估计量。结论GCC的队列研究主要集中在生殖和医学方面。肥胖的孕妇经历CS分娩或大规模分娩的风险增加。需要进行长期研究，以探索与海湾合作委员会地区有关的更广泛的环境和生物暴露以及结局。系统审查注册PROSPERO CRD42017068910。需要进行长期研究，以探索与海湾合作委员会地区有关的更广泛的环境和生物暴露以及结局。系统审查注册PROSPERO CRD42017068910。需要进行长期研究，以探索与海湾合作委员会地区有关的更广泛的环境和生物暴露以及结局。系统审查注册PROSPERO CRD42017068910。