Fat women run greater health risks when they become pregnant

Main Category: Pregnancy / Obstetrics
Article Date: 08 Feb 2004 - 0:00 PDT


Heavy pregnant women run a greater risk of high blood pressure, foetal (fetal) distress and even neonatal death.

(UK spelling: foetal. US spelling: Fetal)

Not only does the obese mother run the risk of serious complications during her pregnancy, she is also sharing risks with her unborn baby (who has a much greater chance of neonatal death).

According to Swedish researchers, women who are planning a pregnancy should be thinking about getting their weight down before getting pregnant.

'We are hopeful] that knowing the problems concerning pregnancy and delivery associated with obesity could possibly motivate young women to prevent excessive weight gain,' says study leader Dr. Marie Cendergren (Obstretician, Linkoping University Ob/Gyn Division, Sweden).

Details of her findings can be found in the February issue of Obstetrics and Gynecology.

She says that she understands that for women suffering from obesity, getting down to a normal level of weight is difficult. However, she stresses that it is the best way to avoid problems (during pregnancy).

A BMI (body mass index) below 30 significantly reduces risks, she stresses. She says that women should aim for a goal (normal BMI for women is between 19 and 26).

In the study they noted the following problems encountered by overweight/obese pregnant women and overweight/obese women planning to get pregnant:

- A higher risk of preeclampsia

- Increased likelihood of C-section (Caesarian)

- Greater risk of dystocia (where the baby's arm or shoulder is damaged during delivery)

- Foetal distress

- Stillbirth

- The baby dying shortly after birth

Cendergren recommends that all obese pregnant mothers should be under the supervision of a high-risk pregnancy expert.

'We must look upon these pregnancies and deliveries as high-risk pregnancies -- particularly the doctors dealing with them,' Cendergren says.

Other doctors (not in this study) have said that even procedures such as ultrasound for the obese pregnant mother can be very hard to carry out successfully.

Some doctors wonder whether the overweight itself is causing the problems. They suggest that maybe the fact that the mother is obese/overweight makes it more difficult for the health professional to get accurate readings and know exactly what to do.

Other doctors say that the general health of the mother is more important than her weight. They say that an overweight healthy mother has a better chance of having a successful pregnancy and delivery than a normal weight unhealthy mother.

The Swedish study looked at nearly 3,500 pregnancies in morbidly obese women -- defined as a body mass index over 40. An additional 12,698 women with a BMI between 35.1 and 40 were also part of the study. All were compared to pregnant women with a normal BMI, falling between 19.8 and 26.

The result: Women with a BMI greater than 40 were at significantly heightened risk for preeclampsia; stillbirth; Caesarean delivery; instrument delivery, (such as forceps); shoulder dystocia; meconium aspiration (a newborn breathing-related procedure), fetal distress; early neonatal death; and large-for-gestational-age -- a problem that can lead to other birth complications.

Although women with a BMI between 35.1 and 40 also were subjected to the same risks, the incidence was notably lower. Indeed, researchers say the lower a woman's BMI, even by just a few points, the lower her risk of problems.

According to Cendergren, the risk of gaining excessive amounts of weight during pregnancy is as detrimental as being very overweight going into the pregnancy.

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