Body mass index is a rough estimate of a person’s body fat based on height and weight. When the body mass index (BMI) is above 30, you are considered obese. Obesity poses numerous potential risks during pregnancy. This means that higher blood pressure, gestational diabetes or pre-eclampsia in the mother develop more quickly. Complications are also more likely to occur in the baby, such as stillbirth or being born larger than normal. Careful weight management, attention to diet and exercise, regular prenatal care and sometimes special rules regarding childbirth are necessary in overweight pregnant women.

• Risk of pregnancy complications in obese mother

• Heart defects
• Maternal mortality
• Preeclampsia
• Sleep apnea
• Gestational diabetes

• Problems with baby due to obesity

• Congenital defects
• Stillbirth
• Macrosomia
• Miscarriage
• Problems with diagnostic studies
• Premature birth

• Complications of obesity during childbirth
• Tips for obese women during pregnancy

• Losing weight if you are overweight
• Medication
• Operation

 

Risk of pregnancy complications in obese mother

Heart defects

Pregnant women who are obese may be at higher risk for changes in the structure and function of the heart. They have a thicker left ventricle (the main pumping chamber of the heart) compared to women of normal weight. Obese women also don’t pump blood as efficiently.

Maternal mortality

Obesity is associated with a higher risk of maternal mortality. These deaths in obese women have many causes, such as preeclampsia and pulmonary embolism (blockage of an artery in the lungs).

Preeclampsia

Obesity is a known risk factor for preeclampsia. Preeclampsia during pregnancy also becomes more severe more quickly in obese women. Preeclampsia is a pregnancy complication in which a woman experiences dangerously high blood pressure during the second half of pregnancy. It is a serious disease that affects a woman’s entire body. Preeclampsia may lead to seizures, liver failure and/or kidney failure. In rare cases, the woman experiences a stroke. In severe cases, emergency treatment is necessary to prevent these complications. Childbirth is sometimes also initiated because the risks for the baby and mother are too great.

Sleep apnea

Sleep apnea is a condition in which a patient stops breathing for short periods of time during sleep. Sleep apnea is associated with obesity. During pregnancy, sleep apnea not only causes fatigue, but this sleep disorder also increases the risk of high blood pressure, preeclampsia, eclampsia and heart and lung disease.

Gestational diabetes

Obese women have a higher risk of gestational diabetes. Gestational diabetes is a condition in which the doctor first diagnoses diabetes mellitus during pregnancy. This condition increases the risk of a cesarean section. Women who have had gestational diabetes also have a higher risk of diabetes in the future, as do their children. Obese women are screened for gestational diabetes early in pregnancy and may also be screened later in pregnancy.

Problems with baby due to obesity

Obesity increases the risk of the following problems during pregnancy:

Congenital defects

Babies born to obese women have an increased risk of birth defects, such as heart defects and neural tube defects.

Stillbirth

The higher the woman’s BMI, the greater the risk of stillbirth.

Macrosomia

Babies born to obese pregnant women are often larger than average. This makes a baby more likely to sustain injury during birth. For example, the baby’s shoulder gets stuck during delivery. Macrosomia also increases the risk of cesarean section. Finally, babies born with too much body fat are more likely to become obese later in life.

Miscarriage

Obese women have an increased risk of miscarriage compared to women of normal weight. Recurrent miscarriages also occur more quickly.

Problems with diagnostic studies

Having too much body fat makes it difficult for the doctor to see certain problems with the baby’s anatomy on an ultrasound. Monitoring the baby’s heart rate during labor is also more difficult in an obese woman.

Premature birth

Problems associated with obesity in pregnant women, such as preeclampsia, are more likely to lead to medically indicated preterm birth. This means that the baby will have to be born early for medical reasons. Premature babies are not yet fully developed. This causes health problems to arise more quickly in the short and long term.

Complications of obesity during childbirth

When an overweight woman gives birth, she is more likely to:

• a blood clot in a deep vein in the leg (deep vein thrombosis) or in the lungs (pulmonary embolism)
• an assisted birth (with forceps or vacuum cup)
• a caesarean section
• a longer hospital stay due to complications
• increased bleeding or heavy bleeding after birth (postpartum bleeding)
• a wound infection if a woman gives birth by caesarean section

 

Tips for obese women during pregnancy

Women who are obese and want to have children should lose weight before they become pregnant. This reduces the risk of problems for the mother and baby. Losing even a little bit of weight (5-7% of current weight) improves overall health and paves the way for a healthier pregnancy.

Losing weight if you are overweight

To lose weight, a woman must use more calories than she takes in. This is possible by exercising regularly and eating healthy food. The midwife refers an obese woman to a nutritionist to start her pregnancy with a healthy diet. Increasing physical activity is important if a woman wants to lose weight. The woman should aim to be moderately active for 60 minutes on most days of the week (e.g. cycling, brisk walking and gardening) or alternatively she can also be vigorously active for 60 minutes (jogging, swimming laps or doing heavy gardening). ). It is also possible to train for twenty minutes three times a day.Some medications help with weight loss / Source: Stevepb, Pixabay

Medication

If, despite diet and exercise changes, a woman still has a BMI of 30 or higher or a BMI of at least 27 with certain medical conditions, such as diabetes or heart disease, medication is recommended. A woman should not use these medications if she is trying to become pregnant or is already pregnant.

Operation

Bariatric surgery (weight loss surgery) is an option for women who are very obese or who have serious health problems due to obesity. If a woman undergoes weight loss surgery, she may not become pregnant until 12-24 months after the surgery. If a woman has had fertility problems, they will disappear spontaneously if a woman loses the excess weight quickly. Some types of bariatric surgery affect the way the body absorbs medications a woman takes through her lungs, including birth control pills. A woman may therefore need to switch to another form of contraception.

read more

• Obesity and pregnancy: Complications and treatment
• Preeclampsia: Serious complication of pregnancy
• Gestational diabetes: Increased blood sugar levels
• Obstructive sleep apnea syndrome (OSAS): Sleep disorder
• Macrosomia: Baby who is much larger than average