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Statistical analysis Using raw data, the percentages of cases in the overweight group and the obese group women were calculated Ibrutinib and also that of the normal weight group. Meta-analysis was performed separately for obese and overweight and risk of CP or CLP using Review Manager software version 5.3 [53]. The OR and 95% Confidence Interval (95% CI) was calculated with a fixed effect model. A P-value of 50% was considered not significant for the test of heterogeneity. Funnel plots were used to examine the risk of publication bias. RESULTS Search results Figure 1 shows a flow diagram of the search result and study selection. There were 106 and 163 articles found in MEDLINE and EMBASE respectively. Google scholar search engine was also searched but no further relevant articles were identified. Of the total 269 articles found, 29 (10.8%) were considered to be potentially relevant by reading their MMP23B titles and abstract. Reviews (n = 2), duplicates (n = 13) and one potentially relevant article with title ��Maternal obesity increases risk of congenital anomalies: a population-based study�� by Mutsaerts et al. [54] were removed. The study by Mutsaerts [54], was presented at the 29th annual meeting of the European Society of Human Reproduction and Embryology, London in July 2013, but only the abstract was available, and there was no full text of the article therefore it could not be considered. Figure 1 Flow diagram of study selection process (adapted from PRISMA statement). At this point, thirteen articles were left of which seven had to be discarded for not meeting the inclusion criteria. Tables 1 - 3 summarize the description of the excluded case control, cohort and cross sectional studies respectively. Table 1 Description of excluded case control studies Table 2 Description of excluded cohort studies Table 3 Description of excluded cross sectional studies The main reason for not including check details potentially relevant articles for this systematic review was due to the discrepancies in classification of weight. Most studies did not use the WHO recommended method of classifying BMI to define obesity, overweight or normal weight [44,45,47,68]. For example, in Cedegren and Kallen��s [44] study, normal weight was classified as a BMI of 19.8 to 26 instead of WHO recommendation of 18.5 to 24.9. Shaw et al. [47] compared obesity, which they regarded as a BMI of > 29 with the reference weight which was BMI