Abstract
Obesity is the most common complication to pregnancy with 16% to 30% of women worldwide living with high weights. Obesity has been defined solely by body mass index (BMI) without consideration of individual metabolic health. Neither most research nor research-based perinatal management guidelines have distinguished between metabolically healthy individuals and those with obesity related diseases. Several international medical organizations now recommend holistic health assessments that include screening for metabolic disorders in addition to BMI measurement, along with care recommendations tailored to metabolic health or disease. This article reviews research that studied outcomes for pregnant individuals living with obesity, who were stratified by metabolic health or disease, and their pregnancy outcomes. Additionally, methods for holistic health assessment during pregnancy are reviewed along with management for preclinical and clinical obesity based on international guidelines.