Some pregnant women become concerned about weight gain during pregnancy and are worried that losing their “baby weight” might be difficult. However, obese pregnant women may face even more serious concerns because of the numerous complications that are associated with obesity. Obesity, or excessive body fat, is measured with a calculation of height and weight and is called Body Mass Index or BMI. Individuals with a BMI over 30 are considered obese and women with higher BMI may have trouble becoming pregnant and may also experience more complications. Unfortunately, they are also at increased risk of stillbirths and miscarriages.
Obesity in pregnancy can lead to increased risk of a myriad of complications. Various infection rates are higher for obese pregnant women including urinary tract infections, kidney infections, and post-partum infections after birth of the baby. Gestational diabetes, which is diabetes that develops during pregnancy, is more common for obese women. As the pregnancy advances, obese pregnant women are more likely to have preeclampsia, which can be a serious problem of high blood pressure.
Obesity can also increase a pregnant woman’s chances of developing blood clots during pregnancy, a condition called thrombosis. Obesity can also affect end-of-pregnancy issues, such as more complicated labors and deliveries. Some obese women have problems with epidurals, which can relieve pain during labor. Obese women are more likely to have higher caesarian section rates, as well as C-section complications like infections.
Babies born to obese women tend to be larger than average weight at birth, a term called macrosomia. Some studies have indicated that higher birth weights are often associated with higher rates of childhood obesity. In addition to increased rates of obesity, children born to obese mothers may have higher rates of birth defects and chronic health problems such as heart disease and diabetes.
Increased risk for mothers and babies warrants special care from your obstetrician. If you are obese and not yet pregnant, pre-conception counseling is very important and can help to work on your overall health before becoming pregnant. Since infertility is more common in obese women, pre-conception counseling will also allow your provider to deal with any matters that might need to be addressed.
Prenatal care is important for all pregnant women but especially so for women who may have extra risks associated with their pregnancy. Your health care provider will be mindful of the predispositions for gestational diabetes, as well as other fetal risks and may hasten some timetables for antenatal testing. Typically, pregnant women are screened for gestational diabetes between 24 to 28 weeks of pregnancy. Obese women may be screened as early as their first new obstetrical visit.
All pregnant women will receive ultrasounds at some point in their pregnancy to check the health of their fetus. Obese patients may require more frequent ultrasounds to monitor the health of their babies as the pregnancy progresses. Additionally, their health care provider may want to see them more frequently than the normal pregnancy to keep closer tabs on blood pressure and weight gain. All pregnancies have guidelines for suggested amounts of weight to gain during a pregnancy. Typical weight gain for an average weight woman is between 25-35 pounds during her pregnancy. Obese women should try to limit their weight gain to between 11 to 20 pounds.
Your health care provider is an excellent resource to help you navigate both your diet and exercise choices during pregnancy. Some providers may refer you to a dietician to help formulate a diet that will give you the necessary caloric intake for a healthy pregnancy but help you limit the amount of weight you gain. Eating a balanced diet of lean proteins, vegetables, fruits, and whole grains can help provide adequate nutrients for both you and your growing baby. Dieticians can help recommend healthy food choices that help make you feel satisfied and not hungry. Planned weight loss programs like Weight Watchers can be followed during pregnancy as long as you allow for sufficient daily calories. Mindful eating, which is a component of many programs, will help you make wiser food choices. Likewise, exercise appropriate for pregnancy is an excellent way to limit the weight you gain during pregnancy. Walking and light aerobic exercise help burn calories and build stamina that will come in handy during labor.
With proper prenatal care, an obese woman can stay on top of any challenges she may face during her pregnancy. In fact, changes made during pregnancy are often an excellent “jump start” to developing healthy habits that she can maintain well after the pregnancy is over.
Dr. Hardy practices obstetrics and gynecology at Atlantic Ob/Gyn with locations in Va. Beach and Chesapeake. Please call 757-463-1234 or visit www.atlanticobgyn.com.