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Santos S, Voerman E, Amiano P, et\u00a0al. Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts. <i>BJOG<\/i>. 2019;126:984\u2013995.","DOI":"10.1111\/1471-0528.15661"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Goldstein RF, Abell SK, Ranasinha S, et\u00a0al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. <i>JAMA<\/i>. 2017;317:2207\u20132225.","DOI":"10.1001\/jama.2017.3635"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Han Z, Mulla S, Beyene J, Liao G, McDonald SD; Knowledge Synthesis Group. Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. <i>Int J Epidemiol<\/i>. 2011;40:65\u2013101.","DOI":"10.1093\/ije\/dyq195"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Yu Z, Han S, Zhu J, Sun X, Ji C, Guo X. Pre-pregnancy body mass index in relation to infant birth weight and offspring overweight\/obesity: a systematic review and meta-analysis. <i>PLoS One<\/i>. 2013;8:e61627.","DOI":"10.1371\/journal.pone.0061627"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Barker DJ. The fetal and infant origins of adult disease. <i>BMJ<\/i>. 1990;301:1111.","DOI":"10.1136\/bmj.301.6761.1111"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Gluckman PD, Hanson MA, Cooper C, Thornburg KL. Effect of in utero and early-life conditions on adult health and disease. <i>N Engl J Med<\/i>. 2008;359:61\u201373.","DOI":"10.1056\/NEJMra0708473"},{"key":"7","unstructured":"7. National health and nutrition survey in Japan [homepage on the Internet]: c2021. https:\/\/www.mhlw.go.jp\/content\/10900000\/000687163.pdf; 2019 Accessed 19.08.2025."},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Hayashi K, Matsuda Y, Kawamichi Y, Shiozaki A, Saito S. Smoking during pregnancy increases risks of various obstetric complications: a case-cohort study of the Japan Perinatal Registry Network database. <i>J Epidemiol<\/i>. 2011;21:61\u201366.","DOI":"10.2188\/jea.JE20100092"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9. Suzuki K, Kondo N, Sato M, Tanaka T, Ando D, Yamagata Z. Gender differences in the association between maternal smoking during pregnancy and childhood growth trajectories: multilevel analysis. <i>Int J Obes (Lond)<\/i>. 2011;35:53\u201359.","DOI":"10.1038\/ijo.2010.198"},{"key":"10","doi-asserted-by":"crossref","unstructured":"10. Morisaki N, Nagata C, Jwa SC, et\u00a0al. Pre-pregnancy BMI-specific optimal gestational weight gain for women in Japan. <i>J Epidemiol<\/i>. 2017;27:492\u2013498.","DOI":"10.1016\/j.je.2016.09.013"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11. Rahman MM, Abe SK, Kanda M, et\u00a0al. Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis. <i>Obes Rev<\/i>. 2015;16:758\u2013770.","DOI":"10.1111\/obr.12293"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Page MJ, McKenzie JE, Bossuyt PM, et\u00a0al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. <i>BMJ<\/i>. 2021;372:n71.","DOI":"10.1136\/bmj.n71"},{"key":"13","unstructured":"13. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. <i>World Health Organ Tech Rep Ser<\/i>. 2000;894:i\u2013xii, 1\u2013253."},{"key":"14","unstructured":"14. Ichijo M, Fukui Y. Report of the Committee on Nutritional Issues: current status survey of the posture of women (non-pregnant and pregnant women) and fetuses and newborns [Normal Group]. <i>Acta Obstet Gynaecol Jpn<\/i>. 1988;40:1487\u20131492 (in Japanese)."},{"key":"15","unstructured":"15. Ogawa Y, Iwamura T, Kuriya N, et\u00a0al. Birth size standards by gestational age for Japanese neonates. <i>Acta Neonatol Jpn<\/i>. 1998;34:624\u2013632 (in Japanese)."},{"key":"16","unstructured":"16. Wells GA. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Presented at: 3rd Symposium on Systematic Reviews: Beyond the Basics; July 3\u20135, 2000; Oxford, United Kingdom."},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. <i>BMJ<\/i>. 2003;327:557\u2013560.","DOI":"10.1136\/bmj.327.7414.557"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Sterne JA, Sutton AJ, Ioannidis JP, et\u00a0al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. <i>BMJ<\/i>. 2011;343:d4002.","DOI":"10.1136\/bmj.d4002"},{"key":"19","unstructured":"19. Akamatsu K, Ebii Y, Hayashi M, et\u00a0al. Analysis of factors affecting the duration of labor: from the data of 1,069 cases at Clinic A. <i>Hyogo-ken Bosei Eisei Gakkaishi<\/i>. 2008;14:30\u201335 (in Japanese)."},{"key":"20","unstructured":"20. Aoki C. Maternal nutritional status and fetal development. <i>J Med Soc Toho Univ<\/i>. 2010;57:169\u2013171 (in Japanese)."},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Chihara I, Uehara R, Kotani K, et\u00a0al. The effect of prepregnancy body mass index on singleton cesarean delivery among term nulliparous women in Japanese population. <i>Arch Gynecol Obstet<\/i>. 2011;284:1117\u20131122.","DOI":"10.1007\/s00404-010-1812-7"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Enomoto K, Aoki S, Toma R, Fujiwara K, Sakamaki K, Hirahara F. Pregnancy outcomes based on pre-pregnancy body mass index in Japanese women. <i>PLoS One<\/i>. 2016;11:e0157081.","DOI":"10.1371\/journal.pone.0157081"},{"key":"23","unstructured":"23. Fujimoto H, Takenoue K. The influence of pre-pregnancy BMI on gestational weight gain and birth weight and related factors: focusing on the occurrence of LGA. <i>Bosei Eisei<\/i>. 2014;54:530\u2013538 (in Japanese)."},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Fujiwara K, Aoki S, Kurasawa K, Okuda M, Takahashi T, Hirahara F. Associations of maternal pre-pregnancy underweight with small-for-gestational-age and spontaneous preterm birth, and optimal gestational weight gain in Japanese women. <i>J Obstet Gynaecol Res<\/i>. 2014;40:988\u2013994.","DOI":"10.1111\/jog.12283"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Harita N, Kariya M, Hayashi T, et\u00a0al. Gestational bodyweight gain among underweight Japanese women related to small-for-gestational-age birth. <i>J Obstet Gynaecol Res<\/i>. 2012;38:1137\u20131144.","DOI":"10.1111\/j.1447-0756.2012.01848.x"},{"key":"26","unstructured":"26. Hyodo S, Masumoto A, Noda K, Mori T. Perinatal problems in pregnant women with thinness. <i>Sanfujinka No Jissai<\/i>. 2002;51:2277\u20132282 (in Japanese)."},{"key":"27","unstructured":"27. Imai K, Fuchino K, Yorifuji H, Koda H. The influence of maternal weight on pregnancy and delivery. <i>Sanfujinka No Jissai<\/i>. 2004;53:1511\u20131515 (in Japanese)."},{"key":"28","unstructured":"28. Ishioka Y, Yamashita H, Hamaguchi K, Kuwahara Y, Nakamura K, Nakatsuka M. Gestational outcomes and birth weight in Japanese women at the upper and lower limits of the normal BMI range. <i>Acta Med Okayama<\/i>. 2022;76:519\u2013526."},{"key":"29","doi-asserted-by":"crossref","unstructured":"29. Kaimura M, Oda M, Mitsubuchi H, Ohba T, Katoh T. Participant characteristics in the Kumamoto University Regional Center of Japan Environment and Children\u2019s Study (JECS): association of pregnancy outcomes with pregestational maternal body mass index and maternal weight gain during pregnancy. <i>Nihon Eiseigaku Zasshi<\/i>. 2017;72:128\u2013134 (in Japanese).","DOI":"10.1265\/jjh.72.128"},{"key":"30","doi-asserted-by":"crossref","unstructured":"30. Kasuga Y, Shigemi D, Tamagawa M, et\u00a0al. Size for gestational age at birth according to offspring sex and gestational weight gain in underweight women. <i>J Dev Orig Health Dis<\/i>. 2019;10:536\u2013541.","DOI":"10.1017\/S2040174418001150"},{"key":"31","unstructured":"31. Kawahara N, Matsutake Y, Tanba M, Watanabe Y. A survey on pre-pregnancy BMI and BMI at delivery and their relation to delivery abnormalities: a survey of midwifery records at K Hospital over the past two years. <i>Kagawa Bosei Eisei Gakkaishi<\/i>. 2009;9:31\u201336 (in Japanese)."},{"key":"32","unstructured":"32. Kobayashi K, Saito I, Nishi M. Weight changes in pregnant women according to pre-pregnancy BMI. <i>Nihon Kango Gakkai Ronbunshu Bosei Kango<\/i>. 2010;45\u201347 (in Japanese)."},{"key":"33","unstructured":"33. Murai U, Nomura K, Kido M, Takeuchi T, Sugimoto M, Rahman M. Pre-pregnancy body mass index as a predictor of low birth weight infants in Japan. <i>Asia Pac J Clin Nutr<\/i>. 2017;26:434\u2013437."},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. Murata T, Kyozuka H, Yamaguchi A, et\u00a0al. 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Severity of low pre-pregnancy body mass index and perinatal outcomes: the Japan Environment and Children\u2019s Study. <i>BMC Pregnancy Childbirth<\/i>. 2022;22:121.","DOI":"10.1186\/s12884-022-04418-3"},{"key":"38","unstructured":"38. Nishii A, Ohkawara S, Noda Y, et\u00a0al. Relationship between birth weight and mother\u2019s weight\u2014focusing on SGA. <i>Nihon Sanka Fujinka Gakkai Kanto Rengo Chihobukai Kaiho<\/i>. 2007;44:37\u201341 (in Japanese)."},{"key":"39","unstructured":"39. Nobumoto E, Okimoto N, Hayata K, et\u00a0al. The current status and perinatal complications of lean pregnant woman in Okayama University. <i>J Soc Perinat Neonatal Med<\/i>. 2013;49:949\u2013952 (in Japanese)."},{"key":"40","unstructured":"40. Shiina Y, Takahashi H. A study of various factors related to perinatal outcomes. <i>Sanfujinka No Jissai<\/i>. 2004;53:1533\u20131538 (in Japanese)."},{"key":"41","doi-asserted-by":"crossref","unstructured":"41. Suzuki K, Nomura K, Takenoshita S, Ando K, Kido M. Combination of parity and pre-pregnancy BMI and low birth weight infants among Japanese women of reproductive age. <i>Ind Health<\/i>. 2016;54:515\u2013520.","DOI":"10.2486\/indhealth.2016-0088"},{"key":"42","unstructured":"42. Takahashi S, Kikuchi M, Watanabe T. The correlation of pregnancy complications with pregnant BMI. <i>Akita Daigaku Igakubu Hoken Gakubu Kiyo<\/i>. 2007;15:51\u201357 (in Japanese)."},{"key":"43","doi-asserted-by":"crossref","unstructured":"43. Takeda J, Morisaki N, Itakura A, et\u00a0al. Investigation of optimal weight gain during pregnancy: a retrospective analysis of the Japanese perinatal registry database. <i>J Obstet Gynaecol Res<\/i>. 2024;50:403\u2013423.","DOI":"10.1111\/jog.15863"},{"key":"44","unstructured":"44. Takimoto H, Kusama K, Yoshiike N, Fukuoka H. Factors affecting the birth weight of full-term singleton infants. <i>Sanfujinka No Jissai<\/i>. 2006;55:1277\u20131284 (in Japanese)."},{"key":"45","doi-asserted-by":"crossref","unstructured":"45. 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Low birth weight and abnormal pre-pregnancy body mass index were at higher risk for hypertensive disorders of pregnancy. <i>Pregnancy Hypertens<\/i>. 2020;22:119\u2013125.","DOI":"10.1016\/j.preghy.2020.08.001"},{"key":"49","doi-asserted-by":"crossref","unstructured":"49. Wataba K, Mizutani T, Wasada K, Morine M, Sugiyama T, Suehara N. Impact of prepregnant body mass index and maternal weight gain on the risk of pregnancy complications in Japanese women. <i>Acta Obstet Gynecol Scand<\/i>. 2006;85:269\u2013276.","DOI":"10.1080\/00016340500502044"},{"key":"50","unstructured":"50. Wataba K, Kadowaki K, Hamanaka T, Ohira Y, Kachi T, Sueharai N. Changes in maternal body weight during pregnancy. <i>Diabetes Pregnancy<\/i>. 2003;3:22\u201326 (in Japanese)."},{"key":"51","doi-asserted-by":"crossref","unstructured":"51. Watanabe H, Inoue K, Doi M, et\u00a0al. 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