With the obesity epidemic on the rise, it is important to address all the demographics encompassed. Unfortunately, this includes pregnant women. But the catch here, is that obesity in pregnant women doesn’t just entail negative effects for the woman, it also involves damaging effects for the fetus. Additionally, obesity before pregnancy is just as critical as during pregnancy1. Obesity during all stages of pregnancy have implications for disease and negative conditions for not only the mother but the baby as well1. Fortunately, studies have been conducted to analyze the best approach for weight management for these mothers-to-be. However, it is important to understand the complications associated with obesity during pregnancy, before figuring out a solution to the problem.
Mothers who are overweight or obese before or during pregnancy have shown increased risk for some conditions such as gestational hypertension, pre-eclampsia, gestational diabetes, and caesarean-section. Diabetes is also another concern for these individuals. All these conditions not only negatively affect the mother, but can have negative outcomes for the babies as well. Additionally, obesity pre-pregnancy can have many negative effects on the pregnancy itself mainly caesarean-section birth and postpartum hemorrhage. The risks for all the above-mentioned conditions increases upwards of 13-fold in women who are obese. Weight gain during pregnancy, above IOM recommendations is also frequently seen with obese pregnant women1. These outcomes will, in turn, affect post pregnancy conditions for the mother and baby. For the mother, postpartum weight retention was much higher in obese mothers than in their normal weight counterparts1. This can be accounted to preexisting weight above recommended levels before and during pregnancy. Babies born from obese mothers were also seen to weigh more than their normal weight born counterparts 1 year postpartum. Another component of the appearance of weight retention or loss was the practice of breast feeding. Mothers who breastfed postpartum were less likely to retain weight gained during pregnancy, than mothers who did not breastfeed1. However, it is important to note that women who are obese tend to have more frequent typical complications with breastfeeding than their normal weight counterparts1. Special attention should be paid to this trend. Fertility was another status that was impacted by weight status. Women who were obese had lower fertility and fecundity than normal weight women1. Menses was also affected and was more irregular in obese woman than normal weight women1.
The babies born from obese women are unfortunately also at a higher risk for detrimental conditions. Preterm delivery is a major concern for babies of obese women1. This is one of the most common causes for low birth weight which increases baby mortality. However, if babies born to obese women are not preterm, they are at risk for increased weight than their normal weight born counterparts1. Increased risk for birth defects is also seen in babies born from obese women1. Particularly, anorectal atresia, hypospadias, omphalocele, hydrocephaly, and cleft lip and palate are a concern1.
Thankfully, there are treatment plans that could reduce the risk for these conditions in both the mother and child. There are several approaches for intervention for women at all stages of pregnancy. The most effective plan of action is to institute diet changes as instructed by a registered dietician, accompanied by an increase in physical activity and lifestyle choices like breast feeding1. Additionally, the best intervention program involves frequent updating in person with a professional, rather than email follow ups or brochure information handouts1. Educational classes on weight management, health diet through pregnancy, and breast feeding, are the best programs for pregnant women to seek out and become involved in1. The more frequent the accountability, the better. Ultimately education and proactive treatment plans are the best solutions for pregnant or hopeful pregnant women to manage weight and other obesity-associated conditions.
- Stang J, Huffman LG. Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes. J Acad Nutr Diet. 2016 Apr;116(4):677-691.