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Hence, we performed meta\u2010analyses following the MOOSE<\/jats:styled-content> (Meta\u2010Analysis of Observational Studies in Epidemiology) guideline, searching M<\/jats:styled-content>edline and E<\/jats:styled-content>mbase from their inceptions. To examine graded relationships, we compared Class III<\/jats:styled-content> obesity to Class I<\/jats:styled-content> and I<\/jats:styled-content>\/II<\/jats:styled-content>, and separately to normal weight. We found important effects on all three primary outcomes in morbidly obese women: preterm birth <37 weeks was 31% higher compared with Class I<\/jats:styled-content> (relative risk [RR<\/jats:styled-content>] 1.31 [1.19, 1.43]) and 20% higher than Class I<\/jats:styled-content>\/II<\/jats:styled-content> (RR<\/jats:styled-content> 1.20 [1.13, 1.27]), large\u2010for\u2010gestational age was higher (RR<\/jats:styled-content> 1.37 [1.29, 1.45] and RR<\/jats:styled-content> 1.30 [1.24, 1.36] compared with Class I<\/jats:styled-content> and I<\/jats:styled-content>\/II<\/jats:styled-content>, respectively), while small\u2010for\u2010gestational age was lower (RR<\/jats:styled-content> 0.89 [0.84, 0.93] compared with Class I<\/jats:styled-content>, with nearly identical reductions for Class I<\/jats:styled-content>\/II<\/jats:styled-content>). Morbidly obese women have higher risks of preterm birth, large\u2010for\u2010gestational age and numerous other adverse maternal and infant health outcomes, relative to not only normal weight but also Class I<\/jats:styled-content> or I<\/jats:styled-content>\/II<\/jats:styled-content> obese women. These findings have important implications for screening and care of morbidly obese pregnant women, to try to decrease adverse outcomes.<\/jats:p>","DOI":"10.1111\/obr.12283","type":"journal-article","created":{"date-parts":[[2015,4,24]],"date-time":"2015-04-24T12:04:57Z","timestamp":1429877097000},"page":"531-546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["The effects of morbid obesity on maternal and neonatal health outcomes: a systematic review and meta\u2010analyses"],"prefix":"10.1111","volume":"16","author":[{"given":"O.","family":"Lutsiv","sequence":"first","affiliation":[{"name":"Department of Obstetrics & Gynecology McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Mah","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Beyene","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology & Biostatistics McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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