From the Guidelines
Obesity during pregnancy poses significant risks to both the mother and the offspring. The overall consensus of the evidence suggests that obesity in pregnancy is associated with an increased risk of adverse outcomes, including gestational diabetes, preeclampsia, and caesarean section, as well as long-term health risks for both the mother and offspring, such as cardiovascular disease, diabetes, and hypertension 1.
Key Risks Associated with Obesity in Pregnancy
- Gestational diabetes: Obesity in pregnancy increases the risk of gestational diabetes, with rates doubling between 1996 and 2010 1.
- Preeclampsia and gestational hypertension: Rates of preeclampsia and gestational hypertension increased by 25% and 184%, respectively, in the United States between 1987 and 2004 1.
- Fetal risks: The fetuses of mothers affected by obesity are at risk of both overgrowth and growth restriction, stillbirth, and birth injury 1.
- Long-term health risks: Obesity in pregnancy can pose long-term adverse health outcomes for both the mother and offspring, including cardiovascular disease, diabetes, hypertension, and future obesity among the offspring 1.
Importance of Healthy Lifestyle Interventions
Simple healthy lifestyle interventions based on the strongest evidence can successfully limit excess weight gain during pregnancy and significantly improve outcomes for mothers and babies 1. These interventions are proven to be cost-effective and can help prevent unhealthy weight gain and reverse the significant adverse health outcomes for women and the next generation 1.
Need for Consistent Clinical Care and Guidelines
Given the well-documented association between pregnant women with obesity and adverse outcomes, there is a need for consistent clinical care that follows best evidence-based practice 1. The quality and consistency of existing clinical practice guidelines (CPGs) for pregnant women with obesity are currently unknown, highlighting the need for rigorous updating and implementation of healthy lifestyle support for women 1.
From the Research
Risks Associated with Obesity During Pregnancy
- Maternal obesity is associated with increased risks of miscarriage, gestational diabetes, preeclampsia, venous thromboembolism, induced labour, caesarean section, anaesthetic complications, and wound infections 2
- Obesity during pregnancy also increases the risk of stillbirth, congenital anomalies, prematurity, macrosomia, and neonatal death for the baby 2, 3
- Intrauterine exposure to obesity is linked to an increased risk of developing obesity and metabolic disorders in childhood 2, 4
Maternal and Fetal Complications
- Women with obesity are at increased risk of gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-GA infants, and higher incidence of congenital defects 5, 4
- Maternal obesity is associated with increased risks of gestational diabetes, pre-eclampsia, caesarean section, and up to 50% of women will develop type 2 diabetes later in life 3
- Offspring of obese mothers have an increased risk of obstetric morbidity and mortality, and a long-term risk of childhood obesity and metabolic dysfunction 3, 4
Management and Prevention
- Adequate management of obesity and gestational diabetes includes modifications in diet and physical activity, with drug therapy considered when medical nutrition therapy and moderate physical activity fail to achieve treatment goals 3
- Pre-conception planning and reducing risks during pregnancy can improve the quality of life for women with obesity 3, 5
- Addressing weight stigma as a barrier to care and developing policies and guidelines to improve care can also help mitigate the risks associated with obesity during pregnancy 5