How Can Obesity Affect Pregnancy?

Obesity in pregnancy increases the risk of complications for both the mother and the baby, including gestational diabetes and high blood pressure. It can also lead to difficulties during labor and delivery.

From 2016 to 2019, obesity rates in the US increased significantly from 26.1% to 29.0%. This is particularly alarming for expectant mothers, as over half of them are struggling with obesity, with 8% falling into the severely obese category.

In this article, you will learn about the detailed effects of obesity on pregnancy and explore effective measures to ensure a healthy pregnancy journey.

What is Obesity?

Obesity is a medical condition characterized by excessive or abnormal fat accumulation in the body that can lead to health problems.

It is defined by a body mass index (BMI) of 30 or higher, calculated by dividing a person's weight in kilograms by the square of their height in meters.

Obesity is not just a cosmetic concern but a medical problem that increases the risk of other diseases and health problems, such as:

• Heart disease
• Diabetes
• High blood pressure
• Cancers

Since obesity is a medical problem that increases the risk of other diseases and health problems, It can also have an impact on pregnancy.

How Can Obesity Affect Pregnancy?

When a woman is obese and becomes pregnant, she may experience several health complications that can put her and the baby at risk. Obese pregnant women may also face challenges in managing their weight gain, which can further increase the risk of complications during pregnancy.

Some possible complications associated with obesity during pregnancy include:

Gestational Hypertension

Gestational hypertension is a type of high blood pressure that occurs during pregnancy, typically after 20 weeks. It differs from chronic hypertension, which occurs before or in the early stages of pregnancy. Gestational hypertension can lead to serious complications like preeclampsia for both the mother and the fetus.

Most women with gestational hypertension have a slight increase in blood pressure, but some develop severe hypertension, putting them at risk of serious complications. Pregnant people with gestational hypertension are often monitored for signs of preeclampsia and to ensure their blood pressure does not go too high.

Preeclampsia

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, most commonly the liver, and kidneys. It typically occurs after 20 weeks of pregnancy and can range from mild to severe. Some of the signs and symptoms of preeclampsia include:

• High blood pressure: Blood pressure consistently higher than 140/90 mm Hg.
• Proteinuria: The presence of excess protein in the urine.
• Swelling: Swelling in the legs, feet, and hands.
• Weight gain: Sudden weight gain due to fluid retention.
• Headaches: Frequent and severe headaches.
• Visual disturbances: Blurred vision, light sensitivity, or dark spots appearing in the vision.
• Epigastric pain: Pain localized in the upper right abdomen.
• Dyspnea: Difficulty breathing or breathlessness.
• Pulmonary congestion: Accumulation of fluid in the lungs.

If left untreated, preeclampsia can lead to severe complications for both the mother and the baby, including eclampsia, characterized by seizures.

Treatment for preeclampsia may involve:

• Medication
• Bed rest
• Close monitoring of the mother and baby

In severe cases, early delivery of the baby may be required to prevent further complications.

Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is a type of diabetes that can develop during pregnancy in women who did not have diabetes before they were pregnant.

It is caused by the hormones produced by the placenta that can make insulin less effective, a condition called insulin resistance. GDM usually appears during the middle of pregnancy, between 24 and 28 weeks.

Some women may have no symptoms, while others may experience increased thirst, frequent urination, fatigue, and blurred vision.

If left untreated, GDM can cause health problems for both the mother and the baby, including:

• An extra-large baby (macrosomia) can lead to problems during delivery.
• Preterm birth.
• Low blood sugar (hypoglycemia) in the baby after birth.
• Respiratory distress syndrome in the baby.
• Increased risk of developing type 2 diabetes for both the mother and baby later in life.

Delivery of Large-for-Gestational-Age Infants

When a baby is significantly larger than average for their gestational age, it is referred to as fetal macrosomia or being large for gestational age (LGA).

Here are some key points about the delivery of large-for-gestational-age infants:

• Definition: Fetal macrosomia is diagnosed when a newborn weighs more than 8 pounds, 13 ounces (4,000 grams), regardless of gestational age. Being in the 90th percentile or above for weight is considered LGA.
• Causes: Fetal macrosomia can be caused by various factors, including genetics (if the parents are large), maternal diabetes, and maternal obesity.
• Risks: Delivering a large-for-gestational-age infant can pose complications for both the mother and the baby. Some of the risks associated with fetal macrosomia include:
  • Difficult labor and delivery: The baby's size may make it challenging for it to pass through the birth canal, increasing the likelihood of instrumental delivery or cesarean section.
  • Birth injuries: The baby may experience fractures or nerve damage during delivery.
  • Shoulder dystocia: This occurs when the baby's shoulder gets stuck behind the mother's pubic bone during delivery, which can lead to complications and injury.
  • Increased risk of perinatal morbidity: Large-for-gestational-age infants are at higher risk of experiencing health problems shortly after birth, such as low blood sugar levels and respiratory distress syndrome.

Congenital Defects

Babies born to women who are obese have an increased risk of having certain birth defects, including heart and neural tube defects.

Here are some key points about the association between maternal obesity and congenital defects:

• Neural tube defects: Maternal obesity is associated with an increased risk of neural tube defects, such as spina bifida, in infants. A study reported that the odds ratio of developing a neural tube defect in a pregnant obese mother was 1.87 compared to mothers with a normal BMI.
• Heart defects: Studies have shown a link between maternal obesity and an increased risk of congenital heart defects in infants. The study found an association between prepregnancy maternal obesity and heart defects and multiple anomalies. Another study reported that babies born to overweight or obese mothers were twice as likely to have congenital heart defects.
• Other birth defects: Maternal obesity has also been associated with an increased risk of other birth defects, such as omphalocele (a birth defect of the abdominal wall) and multiple anomalies. However, the associations between maternal obesity and certain birth defects may be more modest or absent.

Preterm Birth

Preterm birth is a risk associated with obesity during pregnancy. Preterm birth refers to the delivery of a baby before 37 weeks of pregnancy. Preterm birth can lead to complications for both the mother and the baby, including:

Respiratory Distress Syndrome (RDS)

Babies born prematurely, especially those delivered very early, may have underdeveloped lungs and insufficient levels of surfactant, a substance that helps keep the air sacs in the lungs open. This can lead to respiratory distress syndrome, where the baby experiences difficulty breathing and may require special medical interventions like oxygen therapy or mechanical ventilation to support their lung function.

Infections

Premature infants are more susceptible to infections due to their underdeveloped immune systems. They may be less able to fight off bacteria and viruses, making them prone to conditions such as sepsis, pneumonia, and other infections that can be life-threatening.

Developmental Delays

Babies who are born prematurely might experience developmental delays in various aspects, including motor skills, cognitive abilities, and sensory functions. These delays may require early intervention services and ongoing support to ensure the baby's healthy development.

Is it Advisable to Consider Weight Loss Before Pregnancy?

Yes. It is advisable to consider weight loss before pregnancy, especially for individuals who are overweight or have a high BMI. Here are some reasons why:

• Reduces the risk of pregnancy complications: Losing weight before pregnancy can help reduce the risk of complications such as gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-gestational-age infants, congenital defects, and preterm birth.
• Improves maternal and fetal health: Losing weight before pregnancy can improve maternal and fetal health by reducing the risk of health problems for both the mother and the baby.
• Makes it easier to conceive: Being overweight or obese can make it more difficult to conceive, and losing weight can increase the chances of getting pregnant.
• Easier to manage weight gain during pregnancy: Starting pregnancy at a healthy weight can make it easier to manage weight gain, which is important for both maternal and fetal health.

Are There Any Safe Weight Loss Methods During Pregnancy?

No. It is generally not advisable to lose weight during pregnancy, as it can harm the developing fetus. However, for some pregnant individuals, losing weight may be necessary for a healthy pregnancy.

Here are some safe weight loss methods that may be recommended for pregnant individuals:

• Consult with a healthcare provider: Pregnant individuals concerned about their weight should consult with their healthcare provider, who can provide personalized guidance and support throughout the pregnancy and delivery process.
• Eat a balanced diet: Eating a balanced diet that includes:
  • whole grains
  • Fruits
  • Vegetables
  • Lean protein
  • Healthy fats
• Stay hydrated: Drinking plenty of water can help pregnant individuals stay hydrated and may help with weight management.
• Exercise regularly: Regular exercise can help pregnant individuals maintain a healthy weight and reduce the risk of complications during pregnancy. Pregnant individuals should consult with their healthcare provider before starting or continuing an exercise program during pregnancy.
• Avoid unhealthy weight loss methods: Pregnant individuals should avoid unhealthy weight loss methods, such as:
  • Crash diets
  • Fasting
  • Taking weight loss supplements

Weight loss should not be the primary goal during pregnancy, and pregnant individuals should aim to gain a healthy amount of weight based on their pre-pregnancy BMI.

Wrap-Up

Obesity can have a significant impact on pregnancy. It increases the risk of complications such as gestational diabetes, preeclampsia, preterm birth, and stillbirth. Additionally, obese women may require special medical care during pregnancy and delivery.

Maintaining a healthy weight before and during pregnancy is essential to reduce these risks. Eating a balanced diet, exercising regularly, and receiving prenatal care can help prevent complications and ensure a healthy pregnancy.

FAQs on Obesity and Pregnancy

How much should I exercise during pregnancy?

It's recommended to exercise for about 150 minutes per week, with guidance from your healthcare provider. Activities like walking, swimming, and prenatal yoga can be beneficial.

How will my weight be monitored during pregnancy?

Your healthcare provider will regularly measure your weight and track your body mass index (BMI) to ensure healthy weight gain throughout pregnancy.

How does obesity affect labor and delivery?

Obesity can increase the risk of complications during labor and delivery, such as difficult labor, instrumental delivery, and cesarean section, due to the baby's size.

How can I manage my weight after my baby is born?

Gradual postpartum weight loss through a balanced diet and safe exercise is recommended. Prioritize breastfeeding and consult your healthcare provider for guidance.

What is considered a healthy pregnancy weight gain for an obese individual?

Healthy weight gain during pregnancy for obese individuals is generally lower than for those with a normal BMI. Your healthcare provider will provide personalized recommendations.

Can obesity affect my chances of getting pregnant?

Obesity can lead to hormonal imbalances that may affect ovulation and make conceiving challenging. Losing weight before pregnancy can increase your chances of getting pregnant.

Are there specific exercises to avoid during pregnancy if I'm obese?

Certain high-impact or strenuous exercises may not be suitable for pregnant individuals, especially those who are obese. Consult your healthcare provider for safe exercise recommendations.