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Maternal obesity has a significant impact on the risk of fetal and neonatal mortality, and on the development of congenital anomaly, at both individual and population level. This chapter summarizes the available epidemiological evidence, and discusses potential explanations and public health implications. A number of epidemiologic studies have explored the relationship between maternal body mass index (BMI) in early pregnancy and the risk of stillbirth. The impact of maternal obesity on adverse fetal and infant outcomes depends on both rates of obesity, and of adverse pregnancy outcome, in the population in question. Obesity has a complex relationship with socioeconomic status, with higher BMI in women typically correlating with deprivation in developed countries but with wealth in less developed countries. Clinical studies are required to develop and evaluate effective behavioral interventions to reduce weight in women both pre- and post-pregnancy.
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