Professor Shakila Thangaratinam MRCOG, MD, PhD, FRCP Edin

Professor Shakila Thangaratinam

Institute of Metabolism and Systems Research
Dame Hilda Lloyd Chair of Maternal and Perinatal Health
Joint Director of WHO Collaborating Centre for Global Women's Health
Lead for Maternal & Reproductive Health

Contact details

Address
WHO Collaborating Centre for Women's Health
Institute of Translational Medicine
Heritage Building
Mindelsohn Way
B15 2TH

Professor Shakila Thangaratinam is Dame Hilda Lloyd Chair of Maternal and Perinatal Health at the University of Birmingham, and leads the Maternal and Reproductive Health Theme (Jan 2020-). She is the co-Director of WHO Collaborating Centre for Global Women’s Health and academic lead for Women’s Health in Birmingham Health Partners. As Consultant Obstetrician she is involved in the care of high-risk mothers at Birmingham Women’s and Children’s NHS Foundation Trust.

In her previous role as Professor at Queen Mary University of London (2012-2019), Professor Thangaratinam established the Barts Research Centre for Women’s Health (BARC). She established Katie’s Team, a dedicated Patient and Public Involvement group in East London, whose members contribute to NIHR Boards and studies. More recently, she established the Dame Hilda Lloyd Network, which brings together medical and midwifery students and trainees, school students, and senior clinical academics involved in Women’s Health Research in the West Midlands.

To ensure that the views of women in the West Midlands are captured within Professor Thangaratinam’s research at Birmingham, she has established a second Patient and Public Involvement Group named The Hildas. The women in this group are consulted on current research ideas which enables the groups' research to be collaborative.

Professor Thangaratinam’s work focuses on prediction, prevention and treatment of complications in mothers with pre-eclampsia, epilepsy, diabetes, and obesity. She leads large global collaborative networks such as the NIHR-funded International Weight Management in Pregnancy (i-WIP) collaborative group (40 researchers, 16 countries, >50,000 women), with the largest live repository of individual data and the IPPIC (International Prediction of Complications in Pregnancy) collaborative network (73 collaborators, 21 countries, >5 million pregnancies). She has accrued research income of over £20 million, and published in first or last author position in Lancet (2022, 2019, 2015, 2012), BMJ (2022, 2021, 2020, 2017, 2016, 2012, 2011), Lancet Global Health (2017), Lancet Haematology (2021), and multiple HTA monographs. Professor Thangaratinam was awarded the NIHR Senior Investigator Award in March 2021.

Qualifications

Postgraduate qualification

  • FRCP Edin - 2021 (Royal College of Physicians of Edinburgh)
  • PhD - 2011 (University of Birmingham)
  • CCT - 2010
  • MRCOG - 2003
  • MD - 1999 (Dr MGR Medical University, Chennai, India)

Medical School

  • MBBS - 1996 (Dr MGR Medical University, Chennai, India)

Biography

Professor Thangaratinam started her research career as a Clinical Research Fellow at Keele University in 2004, and subsequently joined University of Birmingham in 2006 as a Clinical Lecturer in Obstetrics and Gynaecology. In 2011, she was awarded a PhD in ‘Health Technology Assessments in Maternal and Perinatal Health’.

After the completion of her clinical and academic training, she was appointed by Queen Mary University of London (QMUL) to the post of Clinical Senior Lecturer in 2011, and was a full professor at QMUL between 2012-2019. She established the research support network, Katherine Twining Network (9 NHS hospitals, 3 Universities) in North and East London to deliver women’s health research, and Katie’s Team, the only dedicated and funded Patient and Public Involvement group for Women’s Health in the UK. As R and D Director for Women’s Health at Barts Health NHS Trust until 2019, she was instrumental in integrating research within everyday clinical practice. She was the joint Director of Barts Research Centre for Women’s Health (BARC) and undertook cutting-edge research on the problems facing women and children in East London.

She currently leads a portfolio of work in Women’s Health in areas such metabolic disorders in pregnancy (obesity, gestational diabetes), epilepsy, pre-eclampsia, stillbirth, fetal growth, and preterm birth. She co-leads the WHO Collaborating Centre for Women’s Health at University of Birmingham.

Clinical

She completed her Advanced Training in Specialist Medicine (ATSM) modules in maternal medicine, labour ward management and medical education, and completed her Core Training (CCT) in obstetrics and gynaecology in August 2010 at the Birmingham Women’s Hospital, the largest and busiest tertiary obstetric unit in West Midlands. Her academic work complemented her interest in maternal medicine with projects in pre eclampsia and epilepsy.

She is an Honorary Consultant at Birmingham Women’s and Children’s NHS Foundation Trust.

Teaching

A significant proportion of Prof Thangaratinam’s work is towards the development, support and supervision of junior researchers and students. She is the co-lead for Obstetrics and Gynaecology NIHR IAT (Integrated Academic Training) posts, and is responsible for NIHR ACF and ACL appointments. She contributes to the BMedSci teaching for Women’s Health module, and overall to the UG teaching. She is the academic lead for Obstetrics and Gynaecology at West Midlands Deanery.

Postgraduate supervision

Primary Supervision

Completed

  • PhD Pundir J (2016-2022) Interventions to improve fertility outcomes in polycystic ovary syndrome
  • PhD A Hamilton (2013-2019) Views of women and healthcare professionals on lifestyle interventions in pregnancy
  • PhD B Wattar - (2013-2017) - Improving health outcomes for pregnant women with metabolic risk factors
  • PhD J Allotey (2014-2018) Improving the prediction of adverse pregnancy outcomes
  • PhD E Rogozinska (2014-2017) Diet and physical activity based interventions for antenatal weight management
  • PhD Chiamaka E (2016-2021) Prevention of gestational diabetes and type 2 diabetes in high-risk women
  • MD S Sobhy (2015-2017) Risks of maternal and perinatal outcomes in low and middle-income countries (LMIC)
  • MD F Cheong-See (2012-2017) - Predictors of adverse maternal and fetal outcomes in high risk pregnancies
  • MD Marleen S (2016-2022) Prediction of preterm birth in twin pregnancies
  • MSc M D’Amico (2016) - Clinical trials methodology
  • MSc R Balaji (2021) – Public Health
  • MSc Ansari K (2021-2022) – Covid in pregnancy

In progress

  • PhD Coomar D (2020-)..Preventing Gestational Diabetes Mellitus and related complications in mothers and babies
  • PhD Bolou A (2017-) Effects of lifestyle interventions to prevent type 2 diabetes after gestational diabetes

Research

Professor Thangaratinam leads several national and international collaborative research networks, and her work has influenced national and international guidelines. She undertakes major collaborative work with teams in Monash University, Melbourne; Amsterdam Medical Centre, Amsterdam; WHO, Geneva; CREP, Argentina; Utrecht Medical Centre, Utrecht; Ramon Y Cajal Hospital, Spain.

Current Grants

Chief Investigator

  • MRC Programme grant (2022-2027). £2.1 million. C-safe: Improving maternal and perinatal outcomes through safe and appropriate caesarean sections in low- and middle-income countries
  • NIHR Programme grant (2023-2027). £2.7 million. Epi-Safe: Optimising outcomes in pregnant women with epilepsy and their babies: Reducing maternal seizure risks and assessing long-term safety of antiepileptic drugs

  • MRC (2021-2023). £405k.Calcium Supplementation to Prevent Pre-eclampsia in Low- and Middle-Income Countries: Individual Participant Data (IPD) meta-analysis, network meta-analysis and economic evaluation

  • NHMRC Australia (UK CI) (2020-2022). £114k. Prediction and Prevention of Spontaneous Preterm Birth: An Individual Participant Data Meta-Analysis Comprising of Prognostic and Therapeutic Data

  • NHMRC Australia (UK CI) (2019-2024). £40k. HiPP – Centre of Research Excellence in Health in Preconception and Pregnancy: Prevention of Maternal Obesity

  • NIHR HTA (2021-2022). £315k. Diet and Physical Activity in Pregnancy to Prevent Gestational Diabetes: Individual Participant Data (IPD) meta-analysis on the differential effects of interventions with economic evaluation

Project Lead

  • Midlands Patient Safety Research Centre (2023-2027). £3.7 million (£1.3M Theme). Theme Lead: Maternal health.
  • BRC Birmingham (2023-2027). £36 million (£2M Theme). Theme Lead: Women’s metabolic health

  • Innovate UK (2022-2025). £2 million. Novel Biomarker Test with Treatment, to Predict and Prevent Miscarriage and Adverse Birth Outcomes in Ethnically Diverse Patient Populations

Co-investigator

  • NIHR Efficacy and Mechanism Evaluation (EME): TABLET Trial (Multicentre randomised trial of levothyroxine) £1.4 m (2011-2018)
  • NIHR HTA: A randomised trial of mifepristone and misoprostol versus misoprostol alone for management of missed miscarriage (MifeMiso). £1.8 m (2016-2019).

Chair of Independent Trial Steering Committees

  • NIHR HTA - Alife2 Anticoagulants for Living Foetuses in women with recurrent miscarriage and inherited thrombophilia: randomised trial
  • SOLVE trial: Randomised Controlled Trial of synthetic osmotic dilator for induction of labour

Member of Data Monitoring Committees

  • JGHT - AIMS trial: A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery. 3,412 patients in Malawi, Pakistan, Tanzania, and Uganda; NEJM 2019
  • MRC joint funders – CRADLE trial: Effect of novel vital sign device on maternal mortality and morbidity in low-income countries. 10 clusters in Africa, India, Haiti (536,223 deliveries)

Research Funding Board membership

  • MRC Applied Global health Board (2020-to date) 

  • India Alliance DBT Wellcome
  • Research for Patient Benefit (RfPB) London (2016-2020)
  • Wellbeing of Women, RCOG, London (2017-2019)

Previous Grants

  • Barts Charity (2017-2021). £2 million. Barts Research Centre for Women’s Health (BARC). Prevention of GDM (EMMY), Prevention of Type 2 Diabetes after GDM (OMAHA), Time Lapse Imaging for fertility (TILT)

  • NHMRC Australia (UK CI) (2020-2022). £114k. Prediction and Prevention of Spontaneous Preterm Birth: An Individual Participant Data Meta-Analysis Comprising of Prognostic and Therapeutic Data.

  • NIHR (2020-2021). £224k. Prediction of Fetal Growth Restriction: Individual Participant Data (IPD) Meta-Analysis with Decision Curve Analysis International Prediction of Complications in Pregnancy: (IPPIC-FGR)

  • NIHR HTA (2020-2021). £297K. Diet and physical activity in pregnancy to prevent gestational diabetes: Individual Participant Data (IPD) meta-analysis

  • NHMRC Australia (UK CI) (2018-2020). £125K. IPPIC preterm birth prediction IPD meta-analysis

  • Barts Charity (2014-20). £498K. Effect of Mediterranean diet in preventing pre-eclampsia in women with metabolic risk factors: A randomised controlled trial (ESTEEM)

  • NIHR HTA (2014-2018). £510K. Prediction of pre-eclampsia. IPD meta-analysis (IPPIC pre-eclampsia)

  • NIHR HTA (2016-2018). £983K. GBS2 study

  • NIHR HTA (2013-2015). £250K. Effects of weight management interventions on maternal and fetal outcomes (i-WIP): Individual patient data (IPD) meta-analysis 

Project Lead

  • NIHR HTA (2011-2015). £1.8 million. EMPIRE trial (Antiepileptic drug management in Pregnancy)

  • NIHR HTA (2010-2016). £780K. Prediction of complications in early onset pre-eclampsia (PREP)

  • NIHR HTA (2010-2011). £120K. Interventions to reduce or prevent obesity in pregnant women

Research areas of interest

Metabolic disorders: Obesity, diabetes and polycystic ovary syndrome

Evidence synthesis through NIHR and WHO funded aggregate and Individual Participant Data (IPD) meta-analysis to determine the effects of diet and physical activity in pregnancy. Shakila led the ESTEEM study, the largest randomised trial on Mediterranean diet in pregnancy to prevent maternal and offspring complications. She is currently leading three pilot/feasibility studies funded by Barts Charity and North Thames Collaborations for Leadership in Applied Health Research (CLAHRC): EMmY trial on the effects of myo-inositol to prevent gestational diabetes; prevention of progression to type 2 diabetes in mothers with gestational diabetes with metformin: Optimising health outcomes by using metformin to reduce risk of diabetes after pregnancy (OMAhA); and with Mediterranean diet for prevention of progression to type 2 diabetes in women with gestational diabetes (MERIT).

Maternal and perinatal medicine: Pre-eclampsia, epilepsy, stillbirth, fetal growth, infection

She leads the International Prediction of Complications in Pregnancy (IPPIC) IPD meta-analysis project funded by NIHR HTA and supported by the WHO. The IPPIC collaborative network consists of 73 collaborators from 21 countries, and is the largest global repository of standardised IPD of over three million pregnancies (15 UK, 66 international datasets). She led the Prediction of complications in women with pre-eclampsia (PREP) study funded by NIHR HTA which led to the development of an app that is accurate to predict complications. She led the NIHR HTA funded EMPiRE trial, the first randomised trial involving women with epilepsy. Her work on risk of stillbirth in twin pregnancies (BMJ 2016) garnered significant media attention.

Global Health: Caesarean section, anaemia

Assessment of the safety of caesarean section in Low and Middle Income Countries (LMIC) through large meta-analyses on risks associated with anaesthesia (Lancet Global Health 2016) and the burden of maternal death following caesarean section in LMIC (Lancet 2019). The focus on the effective prevention of anaemia in pregnancy and its complications in women and children with iron fish and also with use of intravenous iron.

Other activities

As Deputy Director of the IMSR since 2020, she is a key member of the Executive Group that supported the Director in developing the vision and strategy of IMSR, successfully steering the Institute during the challenges of the pandemic, contributing to the VCIR, and making key appointments to leadership positions within the Institute. She leads maternal and reproductive health theme at the Institute.

As joint-Director of WHO Collaborating Centre for Global Women’s Health, and academic women’s health lead at Birmingham Health Partners, her responsibilities bridge across Institutes and Institutions.

Prior to that, she led the BARC (Barts Research Centre for Women’s Health) Centre that was established in 2017. She was instrumental in establishing the Katie’s Team, the first fully funded PPIE (Patient and Public Involvement and Engagement) Group dedicated to improving Women’s Health through research. The lay members in the team have co-authored publications, held responsibilities as panel members in NIHR grant funding bodies, and provided input to external teams. At Birmingham, she created a new PPI group for Women in the West Midlands named ‘The Hildas’.

As R and Director of Birmingham Women’s Hospital, she leads the R and D strategy development and delivery. Previously, as R and D Director for Women’s Health at Barts Health NHS Trust (2012-2019), one of the largest number of maternities in Europe, she led the rapid expansion of the department.

Regionally, she established the Dame Hilda Lloyd (DHL) Network that brings together early career and established researchers and clinicians, policy makers and key primary care and public health leaders through a dynamic network that focuses on prioritising the care of Women and their newborns through cutting edge research both within Birmingham and across West Midlands.

Nationally, she led the development of the national RCOG Greentop guideline on epilepsy in pregnancy. As a member of the UK Chief Medical Officers’ infographic development group on physical activity in pregnancy, she was involved in making UK wide recommendations.

Globally, she successfully leads 37 research groups on global project, the i-WIP (International Weight Management in Pregnancy), in collaboration with WHO (World Health Organisation). As lead for the Global IPPIC Collaborative Group, she manages a large network of over 60 research teams involved in prediction studies: IPPIC-pre-eclampsia; IPPIC -stillbirth; and IPPIC-preterm birth. As  part of the international guideline committee she developed guidelines for the management of sub fertility in women with polycystic ovary disease. Her work includes major collaborative work with teams in Monash University, Melbourne; Amsterdam Medical Centre, Amsterdam; WHO, Geneva; CREP, Argentina; Utrecht Medical Centre, Utrecht; Ramon Y Cajal Hospital, Spain.

Publications

Professor Thangaratinam's selected publications

2020-2022

Sheikh J, Allotey J, …..Thangaratinam S. Effects of race and ethnicity on perinatal outcomes in high- and upper-middle-income countries: individual participant data (IPD) meta-analysis of 2,198,655 pregnancies. The Lancet 2022; 400: 2049-2062

Allotey J, Chatterjee S, Kew T... Thangaratinam S. SARS-CoV-2 positivity in offspring and timing of mother-to-child transmission: living systematic review and meta-analysis. BMJ 2022; 376: e067696

Rogozinska E, Daru J, Nicolaides M…. Thangaratinam S. Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systemic review and network meta-analysis. The Lancet Haematology 2021; 8; 7; e503-e512

Allotey J, Stallings E, Bonet M…. Thangaratinam S. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 2020; 370:m3320 (updated 2021)

2014-2019

Sobhy S, Arroyo-Manzano D, Murugesu N, Karthikeyan G, Kumar V, Kaur I, Fernandez E, Gundabattula SR, Betran AP, Khan K, Zamora J, Thangaratinam S. Maternal and perinatal mortality and complications associated with caesarean section in low and middle-income countries: A systematic review and meta-analysis involving 12 million pregnancies. The Lancet. 2019; 393: 1973-1984

Allotey J, Fernandez-Felix BM, Zamora J, Moss N, Bagary M, Kelso A, Khan R, van der Post JAM, Mol BW, Pirie AM, McCorry D, Khan KS, Thangaratinam S. Predicting seizures in pregnant women with epilepsy: Development and external validation of a prognostic model. PLoS Med. 2019;16:e1002802

H Al Wattar B, Dodds J, Placzek A, Beresford L, Spyreli E, Moore A, Gonzalez Carreras FJ, Austin F, Murugesu N, Roseboom TJ, Bes-Rastrollo M, Hitman GA, Hooper R, Khan K, Thangaratinam S; ESTEEM study group. Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM): A pragmatic multicentre randomised trial. PLoS Med. 2019; 23; 16(7): e1002857.

Muglu J, Rather H, Arroyo-Manzano D, Bhattacharya S, Balchin I, Khalil A, Thilaganathan B, Khan KS, Zamora J, Thangaratinam S. Risks of stillbirths and neonatal deaths with advancing gestation at term: a systematic review and meta-analysis of cohort studies of 15 million pregnancies. PLoS Med. 2019; 16(7):e1002838

Daru J, Zamora J, Fernández-Félix BM, Vogel J, Oladapo Olufemi, Morisaki N, Tuncalp O, Torloni MR, Mittal S, Jayaratne K, Lumbiganon P, Togoobaatar G, Thangaratinam S, Khan KS. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis. Lancet Glob Health. 2018;6(5):e548-e554

International Weight Management in Pregnancy (i-WIP) Collaborative Group (Last Author Thangaratinam S) Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ. 2017;358:j3119

Cheong-See F, Schuit E, Arroyo-Manzano D, Khalil A, Barrett J, Joseph KS, Asztalos E, Hack K, Lewi L, Lim A, Liem S, Norman JE, Morrison J, Combs CA, Garite TJ, Maurel K, Serra V, Perales A, Rode L, Worda K, Nassar A, Aboulghar M, Rouse D, Thom E, Breathnach F, Nakayama S, Russo FM, Robinson JN, Dodd JM, Newman RB, Bhattacharya S, Tang S, Mol BW, Zamora J, Thilaganathan B, Thangaratinam S; Global Obstetrics Network (GONet) Collaboration. Prospective risk of stillbirth and neonatal complications in twin pregnancies: systematic review and meta-analysis. BMJ. 2016; 354:i4353.

Viale L, Allotey J, Cheong-See F, Arroyo-Manzano D, Mccorry D, Bagary M, Mignini L, Khan KS, Zamora J, Thangaratinam S; EBM CONNECT Collaboration. Anaesthesia-related maternal mortality in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Glob Health. 2016;4(5):e320-7.

Viale L, Allotey J, Cheong-See F, Arroyo-Manzano D, Mccorry D, Bagary M, Mignini L, Khan KS, Zamora J, Thangaratinam S; EBM CONNECT Collaboration. Epilepsy in pregnancy and reproductive outcomes. The Lancet. 2015; 386(10006):1845-52.

HTA Monographs

Allotey J, Snell KIE, Chan C, Hooper R, Dodds J, Rogozinska E, Khan KS, Poston L, Kenny L, Myers J7, Thilaganathan B, Chappell L, Mol BW, Von Dadelszen P, Ahmed A, Green M, Poon L, Khalil A, Moons KGM, Riley RD, Thangaratinam S; IPPIC Collaborative Network. Accuracy of clinical characteristics, biochemical and ultrasound markers in predicting pre-eclampsia: External validation and development of prediction models using an Individual Participant Data (IPD) meta-analysis Health Technol Assess 2019 (in press)

Thangaratinam S, Allotey J, Marlin N, Mol BW, Von Dadelszen P, Ganzevoort W, Akkermans J, Ahmed A, Daniels J, Deeks J, Ismail K, Barnard AM, Dodds J, Kerry S, Moons C, Riley RD, Khan KS. Development and validation of a prediction model for the risk of adverse outcomes in women with early onset pre-eclampsia (PREP): Prospective cohort study. Health Technol Assess. 2017;21(18):1-100.

Thangaratinam S, Marlin N, Newton S, Weckesser A, Bagary M, Greenhill L, Rikunenko R, D'Amico M, Rogozińska E, Kelso A, Hard K, Coleman J, Moss N, Roberts T, Middleton L, Dodds J, Pullen A, Eldridge S, Pirie A, Denny E, McCorry D, Khan KS. Antiepileptic drug management in pregnancy: A double blind randomised trial on effectiveness and acceptability of monitoring strategies (EMPIRE study). Health Technol Assess. 2018 May;22(23):1-152.

Rogozińska E, Marlin N, Jackson L, Rayanagoudar G, Ruifrok AE, Dodds J, Molyneaux E, van Poppel MN, Poston L, Vinter CA, McAuliffe F, Dodd JM, Owens J, Barakat R, Perales M, Cecatti JG, Surita , Yeo S, Bogaerts A, Devlieger R, Teede H, Harrison C, Haakstad L, Shen GX, Shub A, Beltagy NE, Motahari N, Khoury J, Tonstad S, Luoto R, Kinnunen TI, Guelfi K, Facchinetti F, Petrella E, Phelan S, Scudeller TT, Rauh K, Hauner H, Renault K, de Groot CJ, Sagedal LR, Vistad I, Stafne SN, Mørkved S, Salvesen KÅ, Jensen DM, Vitolo M, Astrup A, Geiker NR, Kerry S, Barton P, Roberts T, Riley RD, Coomarasamy A, Mol BW, Khan KS, Thangaratinam S. Effects of antenatal diet and physical activity on maternal and fetal outcomes: Individual patient data (IPD) meta-analysis and health economic evaluation. Health Technol Assess. 2017;21(41):1-158

2000-2013

Thangaratinam S, Rogozinska E, Jolly K, Glinkowski S, Roseboom T, Tomlinson JW, Kunz R, Mol BW, Coomarasamy A, Khan KS. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012;344:e2088.

Thangaratinam S, Tan A, Knox E, Kilby MD, Franklyn J, Coomarasamy A. Association of thyroid antibodies with miscarriage and preterm birth: A meta-analysis. BMJ 2011; 342:2616

Thangaratinam S, Brown K, Zamora J, Khan KS, Ewer AK. Pulse oximetry screening for critical congenital heart defects (CCHD) in asymptomatic newborn infants: A systematic review and meta analysis involving 229,421 babies. The Lancet 2012.379:2459-2464

Wilson A, Lissauer D, Thangaratinam S, Khan KS, MacArthur C, Coomarasamy A. Clinical officers versus medical doctors for Caesarean surgery in the developing world: A meta-analysis of controlled studies. BMJ 2011; 342:2600

Ewer AK, Middleton LJ, Furmston AT, Bhoyar A, Daniels JP, Thangaratinam S, Deeks JJ, Khan KS; PulseOx Study Group. Pulse oximetry screening for congenital heart defects in newborn infants (PulseOx): a test accuracy study. The Lancet. 2011;378(9793):785-94.

Thangaratinam S, Rogozińska E, Jolly K, Glinkowski S, Duda W, Borowiack E, Roseboom T, Tomlinson J, Walczak J, Kunz R, Mol BW, Coomarasamy A, Khan KS. Interventions to reduce or prevent obesity in pregnant women: a systematic Review. Health Technol Assess. 2012 Jul;16(31):iii-iv, 1-191 

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