The Dangers of Obesity & Pregnancy

More than 50 percent of women between the ages of 20 to 44 are overweight, and one-third of them are considered obese, according to the Centers for Disease Control and Prevention.

Obesity poses a huge risk to a person’s overall health, but when a woman is pregnant, these risks are magnified. Being obese and pregnant increases a woman’s risk for complications — it also can make it more difficult to get pregnant in the first place. The dangers of obesity and pregnancy are well known, but a recent study magnifies the seriousness of these risks.

The study, published by researchers at Boston University School of Public Health, indicates that infants whose mothers were obese before pregnancy may have an increased mortality risk. Researchers reviewed data for more than 6 million newborns and found that infants born to obese mothers were twice as likely to die from preterm birth complications than those born to women with a normal weight. The study found that birth defects also were linked to obesity.

It’s important to understand how we define obesity. It isn’t just an additional 20 or 30 pounds. Obesity is based on formula that compares height to weight, or Body Mass Index (BMI). A person who has a BMI of 30 or higher is considered obese.

Obesity can cause several health problems for a woman and her unborn child, the most significant of which is gestational diabetes. Gestational diabetes occurs when the body doesn’t get enough insulin during pregnancy. If gestational diabetes isn’t properly treated, this can cause the baby’s pancreas to overproduce insulin to compensate for this deficit. This causes the extra insulin to be stored as fat, leading to macrosomia (or “big body”), a condition that puts infants at risk for breathing issues at birth and increases their risk for Type 2 diabetes and obesity when they get older.

Preeclampsia, a complication that involves high blood pressure and damage to other organs, is another risk. Preeclampsia can be fatal for both a woman and her baby, and the only way to treat this condition is to deliver the baby. In addition to preeclampsia, obese pregnant women also are more likely to carry their babies past their expected due date. They also face more issues during labor and have an increased risk of urinary tract infections. Unfortunately, we also see a high rate of stillbirth in women who are obese.

The best way to address these issues is to help women lose weight if they are trying to get pregnant. OBGYNs often refer patients to our practice because we can help them with weight loss. We have seen several women become safely pregnant after undergoing weight loss surgery.

It’s important to understand that weight loss surgery also involves behavioral changes. Some patients have to lose weight before surgery and follow a restrictive diet. Losing weight before surgery reduces the size of the liver, which makes it easier for us to operate and ultimately reduces the risk of complications. There’s another benefit, as well: putting you in the right mindset. If you are able to lose weight before surgery, you’re more likely to stick to a diet, exercise and nutrition program after the procedure.

Weight loss surgery can reduce your risk for gestational diabetes, preeclampsia and other complications during pregnancy. If you undergo surgery, it’s best to wait at least one year to 18 months before you get pregnant. This will allow your weight to stabilize and minimize the risk for maternal and fetal malnutrition and the possibility an infant will be small for his or her gestational stage.

If you are thinking about becoming pregnant and are concerned about your weight, talk to your OBGYN about what you can do. Lifestyle changes can help with weight loss, but if you have a BMI of 30 or higher, weight loss surgery may be a viable option to improve your health and ensure you have a healthy pregnancy.