we need to develop eff ective interventions based on evidence from sub-Saharan Africa.

8are in accordance with previous studies on maternal obesity and neonatal survival from highincome countries, 1,3,4,9 which is reassuring in a scientifi c sense but also alarming. These fi ndings force us to see the global burden of obesity on reproductive health in a new perspective, where complications attributable to maternal obesity in low-income countries may far outnumber the burden seen in affl uent countries. For that reason, we need to acquire and analyse better data addressing these issues from the parts of the world where morbidity and mortality are highest. Regrettably, good longitudinal data on the comparatively rare neonatal deaths in high-income countries have provided little understanding of the mechanisms behind impaired survival in the off spring of obese