Overweight and pregnant
According to World Health Organization (WHO), obesity is considered to be one of the serious health problems of the 21st century. In recent years there is a dramatic increase in obesity among pregnant women. Those women who are overweight and pregnant may have pregnancy related complications. Lets see how it affects the mother and baby and how it can be managed.
Last Updated: 22 October 2020
Obesity is defined as excessive body fat which is likely to impair your health.
You are classified as overweight or obese based on your body mass index (BMI). BMI is a measurement based on your height and weight.
· If your BMI is less than 18.5, you are underweight
· If BMI is 18.5 to 24.9, you maintain a healthy weight
· If it is 25-29.9, you are overweight
· If BMI is between 30 and 40, you are obese
According to WHO, the prevalence of obesity in pregnancy ranges from 1.8 to 25.3%.
Obesity before pregnancyWomen, who are obese or underweight, may have reduced fertility when compared to women who have a healthy weight. This sub fertility could be due to decrease in frequency or complete absence of ovulation. Obese women who conceive through assisted reproductive techniques (ART) may face certain problems (duration of ovarian stimulation, fertilization rate, embryo transfer rate as well as implantation and pregnancy rates).
Problems associated with obesity during pregnancy
Women who are overweight and pregnant may be at a risk of certain health problems.
Gestational Diabetes
Though there are a lot of factors (age, family history) associated with gestational diabetes, obesity is considered to be an independent risk factor for the development of gestational diabetes.
Overweight and pregnant women with gestational diabetes tend to have babies with a higher birth weight.
Preeclampsia
Overweight and pregnant women are two to three times at a higher risk of developing preeclampsia than women with a normal weight.
Cesarean sectionObese women are two folds at an increased risk for undergoing cesarean section.
Also women who are overweight or obese are more susceptible to post-operative complications, such as excessive blood loss, deep venous thrombosis, wound infection and postpartum uterine infection.
Other common problem overweight and pregnant women may face include sleep apnea (a person stops breathing for short periods during sleep), thrombosis (blood clots), preterm birth, a longer labor and heavy bleeding after birth.
Problems for your baby if you are overweight
Miscarriage: The higher a woman’s BMI, greater are the chances of a miscarriage (1 in 4 pregnancies)
· Preterm birth: Problems associated with obesity such as high blood pressure can lead to preterm birth, that is, the baby is delivered at an early date for medical reasons.
· Neural tube defects: Babies born to obese mothers may have higher chances of developing neural tube defects (abnormalities in baby’s skull and spine) and cardiovascular abnormalities.
· Macrosomia: Pregnant women who are obese and have gestational diabetes are at a risk of producing overweight babies (>4kg). This may lead to fetal injury and also baby’s shoulder may get stuck during delivery. Macrosomia increases the chances of a cesarean section. Babies born to overweight women may become obese later in their life.
· Still birth: The chances of still birth (1 in every 100 births in obese women versus 1 in 200 in normal women) increases in obese pregnant women.
· If your BMI is high during pregnancy, you may require additional ultrasound scans to monitor the baby’s growth, development and position. Sometimes excess body fat makes the doctor difficult to visualize the baby’s growth and also makes them difficult to monitor heart beat during labor.
Management of obesity
The recommended gestational weight gain is 11.5 to 16.0 kg (0.5 to 2.0 kg for the first trimester and 0.35 to 0.50 kg per week for the second and third trimesters). Women who are overweight should not exceed this weight gain recommendations.
Before pregnancyLosing weight before pregnancy is the ideal choice to avoid complications in the future. Also weight loss before pregnancy results in a better chance for conception and increases the percentage of live births for obese women with or without poly cystic ovarian syndrome (PCOS).
During pregnancy
Losing weight by dieting during pregnancy is not recommended and this may harm your baby. Concentrate on eating well and do physical exercises.
Healthy eating
A healthy eating will benefit you and your baby.
You can consult a dietician and understand how many calories you require based on your height and weight. She may even give you a weekly plan and start you to stay energetic and active with low calorie foods.
Don’t “Eat for two”
Try eating small meals throughout the day instead of large meals
Drink plenty of water and have fiber rich foods like vegetables, fruits and whole grains.
Choose low glycemic foods.
Don’t suppress your appetite with pills and beverages
Cut out fried foods and sugary drinks
Take your prenatal supplements for folic acid, iron and calcium supplements
Stay Active
Walking, swimming and gardening can help you stay active.
Don’t do any vigorous exercise. Start walking or do any other exercise for 15 minutes and gradually increase the time.
Avoid sitting for a longer period of time.
Take the stairs
Not all obese women have poor pregnancy outcomes. Overweight and pregnant women can have healthy babies. It requires careful monitoring of your weight to reduce the complications.
