Obesity and Pregnancy: What you should know

Obesity has become such a common condition that the implications in pregnancy are often overlooked or under recognized. But many studies highlight the correlation between high BMI and the overall increase of pregnancy-related complications. I want to share some of the potential complications and how you can reduce your risk if you are a person who has obesity and you are considering becoming pregnant.

Knowing the Risks
Obesity during pregnancy can increase several health problems. Gestational hypertension, also known as preeclampsia, can result in seizures, myocardial infarction, and stroke, as well as placental concerns affecting the growth of the fetus.

Obesity also increases the risk for gestational diabetes. Gestational diabetes presents serious implications for both mothers and fetuses, including cesarean section deliveries. It also increases the lifetime rate of diabetes for mothers and their children.

Obesity poses unique risks that extend toward the fetus, such as neural tube defects, cardiac anomalies, and orofacial clefts. It can be more difficult to detect these issues early in patients with obesity. In addition, long-term studies reveal that children born to mothers with obesity have an increased risk for neuropsychiatric disorders, mood disorders, and cognitive impairment.

Finally, the obesity-related disorders in pregnant patients, such as preeclampsia and uncontrolled diabetes, may lead to preterm deliveries, and obesity remains one of the most frequent modifiable risk factors for stillbirth.

Managing the Risks
You can help prevent obesity-associated pregnancy concerns in a number of ways. Ideally, management should begin before pregnancy and continue through the postpartum period and beyond.

Let your doctor know if you are hoping to become pregnant in the coming year. Your doctor can help you access help from a dietitian and other resources with the goal to get your body ready for pregnancy.

Keep a healthy diet. Many women over-indulge in rich foods during pregnancy. It could be that they believe the adage that they are “eating for two.” Pregnancy is also a stressful time. Pregnant patients may be using comfort food to cope with the anxiety of new parenthood.

The food you eat during pregnancy is hugely influential in your own health and the health of the fetus. Choose whole grains, plenty of fruits and vegetables, lean proteins, and healthy fats. Simply avoiding most processed foods alone would be tremendously beneficial for many pregnant patients.

You know that movement has a powerful influence on health for people who are not pregnant. It is just as powerful for those who are. Embrace movement. By doing so, you will reduce all of your obesity-related pregnancy risks and experience the added benefits of feeling better, elevated mood and energy, better sleep, and improved strength and endurance. Talk to your doctor about what sorts of movement would be best for you. 

Make sure to attend your prenatal appointments and get all of the tests your doctor or midwife recommends. An early glucose tolerance test is recommended around 16 weeks. If identified, treatment includes diabetic education, consultations with a dietician, and, sometimes, medication.

Your doctor or midwife may recommend blood pressure monitoring. If so, let them know if your blood pressure is high. They may recommend a low-dose aspirin, which may help reduce the risk of preeclampsia and other obesity-related complications.

Knowing your risks and taking the steps to reduce them will increase your chances of having a healthy pregnancy and a healthy, happy baby.

Kimberley Sampson, MD, FACOG, DABOM, an OB/GYN at SVMC OB/GYN, part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care, in Bennington.