Energy balance

In high-income countries, increased per capita caloric supply and higher urbanization rates are positively associated with a higher number of overweight and obese pregnant women, whereas in lower-middle income countries, a higher percentage of female employment in agriculture (indicating higher occupational physical activity) is inversely associated with this burden.

For policymakers and public health officials, this research highlights that reducing maternal obesity requires systemic changes rather than just individual advice. In high-income nations, strategies should focus on managing caloric supply and mitigating the sedentary effects of urbanization. In lower-income nations, supporting agricultural employment or increasing physical activity in service-sector jobs may help counteract obesity trends.