Pregnancy and weight management
Obesity has become an epidemic, with about five out of 10 women considered as being either overweight or obese. This is an ongoing concern and results in major health problems for women and their babies. During pregnancy, obesity puts both mother and baby at increased risk of complications.
OBESITY AND PREGNANCY
Body Mass Index:
Body mass index (BMI) is a calculated number that helps to determine whether a person is normal weight, overweight, obese or underweight. BMI is calculated by dividing your weight (in Kilograms) by your height (in metres) squared. For calculation, only the pre-pregnancy or early pregnancy weight is taken into consideration. Weight later in pregnancy will overestimate the BMI. For e.g., if your booking in weight is 65 kg and your height is 1.65 meters then BMI is calculated applying the formula:
Weight in kg / Height in meters2 i.e., 65 / 1.65×1.65 = 23.8 (within normal range)
BMI and recommended weight gain during pregnancy:
| BMI | Category | Risk of Complications | Total weight-gain goal during pregnancy |
|---|---|---|---|
| 18.5 or less | Underweight | Increased risk | 12.5 – 18 kg |
| 18.5 – 24.9 | Normal range /healthy weight | No Increased risk | 11.5 – 16 kg |
| 25 – 29.9 | Overweight | No Increased risk | 7 – 11.5 kg |
| 30 – 34.9 | Obese class 1 | Mildly increased risk | 5 – 9 kg |
| 35.0 – 39.9 | Obese class 2 | Moderately increased risk | 5 – 9 kg |
| 40 or more | Obese class 3 | Severely increased risk | Under 5 kg |
www.nhlbisupport.com/bmi Go to for online calculation of BMI.
OBESITY and the risk of complications during pregnancy
This information discussed here is not to alarm you but to provide an insight, awareness and education. This may help you to make right decisions about your diet, exercise, pregnancy planning and weight-loss counselling.
Risks Prior to Pregnancy:
Irregular periods
Irregular ovulation and difficulty conceiving
Pre-existing medical problems like hypertension and diabetes which can worsen during pregnancy. If you are on any medications for medical problems, this will have to be switched over to pregnancy safe medications
Maternal Obesity and Risks to the Baby:
Early miscarriage
Increased risk of stillbirth
Assessment of the fetus during pregnancy can be tricky both by ultrasound and clinical measurement
Higher risk of birth defects such as neural tube defect or spina bifida (i.e., incomplete development of the baby’s spine).
Baby can grow bigger if the mother’s BMI is high to start with or if there is increased weight gain than the recommended weight. Large baby can cause problems during the labour and delivery
Large babies have broad shoulders which can cause difficulty in delivering the baby’s shoulders (shoulder dystocia). Shoulder dystocia may lead to nerve damage in one of the baby’s arms or fracture of the collar bones and rarely other serious problems
During labour there may be difficulty in monitoring the baby’s heart rate
The new born baby can have medical problems like low blood sugar, jaundice or increased likelihood of admission to the neonatal nursery particularly if the mother has developed diabetes in pregnancy
Excessive maternal weight gain during pregnancy can affect the babys metabolism and increases the risks for obesity and diabetes in the babyas a teenager. There is an increased risk of childhood obesity and diabetes.
Risks to the Mother:
More prone to get Gestational Diabetes
Higher risk of developing high blood pressure or gestational hypertension
Risk of developing Preeclampsia. This is a potentially serious condition which may require admission to the hospital or earlier delivery (preterm delivery). The symptoms of this condition include headaches, disturbances in seeing like blurry vision, seeing spots in front of the eyes and sudden swelling of the legs and body
Preterm delivery and premature infants may have a range of health problems that result in lengthy hospitalization and developmental problemsIncreased risk of developing clots in the legs (DVT- deep vein thrombosis) which can spread to the lungs (pulmonary embolism) a serious life threatening condition
The labour can be slow and difficult requiring emergency caesarean section or assistance during delivery with instruments like forceps or vacuum The anaesthetist may find it difficult or may require several attempts to correctly place the catheter for epidural or spinal anaesthesia for pain relief
Caesarean section can be difficult in an obese woman like increased operative time, excessive blood loss, and infection of the wound, wound break down or poor healing. In certain situations however, it may involve less risk to the baby than a complicated vaginal delivery (an abnormally large baby) where fetal monitoring may be compromised due to excess maternal weight or difficult shoulder dystocia
Maternal Risks after Birth:
Risk of DVT (developing clots in the legs)
Difficulty in initiating breast feeding
Postnatal depression
More prone to retain the weight gained duringhypertension, the pregnancy
There is a risk of developing type 2 Diabetes, essential hypertension, cardiovascular disorders, osteoarthritis etc., in future
In subsequent pregnancies the chance of a successful VBAC (vaginal birth after a caesarean section) is much less in women with high BMI
The above risk or complications can be prevented or reduced by careful weight control during the pregnancy
Links:
For healthy eating and choosing safe food during pregnancy please so through this web site: