Obesity and Women’s Health

published on: 22nd february, 2021

Obese pregnant women are at increased risk for an array of maternal and perinatal complications, and the risks are amplified with increasing severity of obesity.

It has been estimated that one-quarter of pregnancy complications (eg, gestational hypertension, preeclampsia, gestational diabetes, preterm birth, large for gestational age infant) are attributable to overweight/obese mothers .Obese mothers with high gestational weight gain have the highest risks of pregnancy complications.

Postnatally, offspring of obese mothers are at increased risk of childhood and adult obesity.

Obstetric providers should be aware of these risks and modify patient care before pregnancy, during pregnancy, and postpartum to reduce the risk of these adverse outcomes.

Obesity is defined as body mass index (BMI) ≥30 kg/m2 . It is further stratified by class: class 1 (BMI 30.0 to 34.9 kg/m2), class 2 (BMI 35.0 to 39.9 kg/m2), and class 3 (BMI ≥40 kg/m2).

This standard definition for the nonpregnant population does not adapt well to the pregnant population since a pregnant woman's weight increases over a relatively short interval of time and much of the weight gain is related to accretion of mass that will be lost at delivery: the fetus, amniotic fluid, and blood. Since no standard pregnancy-specific definition of obesity exists, pregnant women are often considered obese or nonobese based on their prepregnancy BMI.

Having a high BMI during pregnancy increases the risk of various pregnancy /labour complications, including:

• The risk of miscarriage, stillbirth and recurrent miscarriage
• Gestational diabetes
• A pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys (preeclampsia)
• Risk of Cardiac dysfunction or rarely stroke
• Having Sleep apnea can cause fatigue
• Having Longer labour and can be harder to monitor the baby during labour
• Difficulty in delivering the fetus(shoulder dystocia , Erbs palsy )
• Postpartum hemorrhage( inertia and trauma )
• Increasing the need for a C-section and the risk of C-section complications, such as wound infections and bleeding

Having a high BMI during pregnancy has been linked to an increased risk of various health problems for a baby, including:

• Birth defects.
• Being significantly larger than average (fetal macrosomia)
• Impaired growth
• Childhood asthma
• Childhood obesity

Despite the risks, you can have a healthy pregnancy if you are obese. It takes careful management of your weight, attention to diet and exercise, regular prenatal care to monitor for complications, and special considerations for your labor and delivery.