Obesity in Obstetric Anesthesia: A Systematic Review - 07/04/26

Doi : 10.1016/j.jogoh.2026.103179

I. Pasca ^1,^2,^3,^4,^⁎ , L. Soloniuk ^1,^2,^3,^5,⁶, C. Baker ¹, A. Virdi ⁷, M. Botros ⁸, C. Ghobrial ⁹, A. Sinha ¹⁰

¹ Department of Anesthesiology and Perioperative Medicine, Riverside University Health System, Moreno Valley, CA, USA

² Department of Anesthesiology, Loma Linda University, Loma Linda, CA, USA

³ School of Medicine, University of California Riverside, Riverside, CA, USA

⁴ University of California San Diego, La Jolla, CA, USA

⁵ Department of Gynecology and Obstetrics, Riverside University Health System, Moreno Valley, CA, USA

⁶ Department of Gynecology and Obstetrics, Loma Linda University, Loma Linda, CA, USA

⁷ School of Medicine, California University of Science and Medicine, Colton, CA, USA

⁸ School of Medicine, Loma Linda University, Loma Linda, CA, USA

⁹ Department of Family Medicine, University of Alabama, Tuscaloosa, AL, USA

¹⁰ Department of Anesthesiology and Perioperative Medicine, New York Medical College at Saint Mary's General Hospital, Passaic, NJ, USA

^⁎ Corresponding Author: Ioana Pasca, MD FASA, 26520 Cactus Ave, Moreno Valley, CA 92555 26520 Cactus Ave Moreno Valley CA 92555

Sous presse. Manuscrit accepté. Disponible en ligne depuis le Tuesday 07 April 2026

Highlights

•	Maternal obesity significantly increases anesthesia-related risks in obstetric patients.
•	Coordinated, multidisciplinary care is key to improving maternal outcomes with obesity.
•	Maternal and neonatal outcomes vary by mode of delivery, neuraxial anesthesia, medication dosing, and procedural techniques

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Abstract

Maternal obesity presents complex challenges for anesthetic management, with implications spanning neonatal, cardiovascular, airway, neuraxial, and procedural domains. This review synthesizes evidence on how elevated maternal body mass index (BMI) impacts perioperative evaluations, risks, complications, and outcomes, in addition to anesthetic modalities and efficacy in the pregnant population. Given the increasing global prevalence of maternal obesity, anesthesiologists must refine clinical practices, employing tailored, evidence-based strategies to mitigate risks and enhance patient outcomes. This review aims to provide anesthesiologists and obstetricians with key considerations and best practices for managing obstetric anesthesia patients with obesity. Clinical recommendations herein are based on current research and evaluated using Oxford Centre for Evidence-Based Medicine for level of evidence and class of recommendation.

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Keywords : High-risk pregnancy, Obesity, Obstetric anesthesia, Mitigating risk