Maternal Obesity: An Obstetric Risk

The incidence of obesity is increasing at an alarming rate nowadays in all age groups, specifically in women. As the estimate suggests that about 20 percent of women will be obese by 2025. These estimates consider that maternal obesity increases the risk of adverse health outcomes for the mother as well as the child. Obesity has a great impact on the health of the mother and the child during pregnancy as it affects the weight of the child in infancy and beyond. Obesity management during pregnancy is the most important thing and it requires a multi-disciplinary approach. Also, maternal Obesity has a unique set of challenges that doctors must also tackle to attain the best outcome for both the mother and baby.

Defining Obesity in Pregnancy

Obesity is a condition if a person has an excessive accumulation of fat in adipose tissue, which causes health impairment. Maternal health is broadly defined as the health of women during pregnancy and the postpartum period. Almost all women experience maternal obesity syndrome and having a high body mass index during pregnancy significantly impacts the health of you and your baby. Pregnancy Obesity risk is the most common condition in pregnant women. Pregnancy obesity can be both short-term and long-term and both have adverse consequences for both mother and child.

Obesity is sometimes one of the major causes of infertility, spontaneous pregnancy loss, and congenital anomalies. Pregnant women generally have increased insulin resistance in the early stages which leads to late gestation in terms of fetal overgrowth and glucose intolerance. Many women with maternal obesity syndrome suffer after delivery as they are at an increased risk of developing many conditions like depression, thromboembolism, difficulty with breastfeeding, etc. Obesity after pregnancy is the way to developing conditions like cardiometabolic risks and post-pregnancy Obesity.

Obesity increases Pregnancy complications

Pregnancy for obese women is more complicated; having a high BMI can harm fertility by inhibiting regular ovulation. If women have high BMI and have normal ovulation, it can take time to become pregnant. As per some research, higher BMI is linked with an increased risk of unsuccessful in vitro fertilizations too. Before pregnancy, if you are obese, then your chances of maternal Obesity complicate pregnancy in comparison to women who have a healthy weight. Pregnancy for the obese can be difficult sometimes, and Obesity can also affect a typical kind of fertility treatment known as IVF also. If you are overweight, then there are many risks associated with high BMI, and they are:

1. Maternal Obesity causes High blood pressure, preeclampsia, and blood clotting problems

High BP is a common condition experienced by women with maternal obesity syndrome. The condition is when the force of blood against the walls of blood vessels is too high. The condition in pregnant women happens after the 20th week of pregnancy or can be right after pregnancy. The signs of pregnant women with this condition show some signs and presentations such as their organs like kidneys or liver may not be working correctly. In some cases, women also experience clotting problems in which they experience blood clots that partly or entirely block the flow of blood in vessels.

2. Maternal Obesity and Gestational diabetes

It is another condition that is on the top of the pregnancy obesity risk list. It is a condition of diabetes that some women get during pregnancy. Diabetes is a condition in which the body has too much sugar in the blood. It is common for women to have maternal Obesity as it puts them at higher risk of having it after having a baby.

3. Cesarean birth chances

Women with Maternal obesity syndrome also are at higher risk of having to undergo a c-section or cesarean birth instead of being able to give birth vagianally. If you are obese, you are more prone to have this complication and other conditions like an infection or losing too much blood.

4. Risk of Miscarriage or stillbirth

Pregnancy for obese women differs from normal ones as they are at much more risk of miscarriage or stillbirth. Miscarriage is a condition in which a baby dies in the womb before 20 weeks of pregnancy. Stillbirth is when the baby dies in the womb before birth or after 20 weeks of pregnancy.

5. Maternal Obesity and cardiovascular health

There is much evidence that proves the link between maternal Obesity and cardiovascular health. These studies explain the association between the two, i.e., mother and child's Obesity. The higher circulating levels of glucose, free fatty acids, amino acids, and fetal insulin, along with digestive hormones in the mother, are the main cause of appetite control and metabolism in the fetus. It is also transferred to the next generation and also leads r to hypertension and vascular dysfunction. The pregnancy obesity risks also involve elevated risks of cardiovascular anomalies, neural tube defects, and cardiac dysfunction throughout the fetal development stage.

6. Maternal obesity impacts on appetite and the neuroendocrine system

There are some changes noted associated with appetite and activity in offspring owing to c= programming effects on the brain. Maternal obesity syndrome increases the risk for offspring neurodevelopmental disorders and delayed brain development.

 Other complications for women with maternal Obesity 

1. Infections during pregnancy
2. Sleep apnea is a disorder when breathing stops while you are sleeping.
3. A dangerous blood clot problem is also known as venous thromboembolism
4. Inducing labor is a condition when your doctor
5. offers you medicine or breaks your water to start the labor process.
6. Women can also experience problems in breastfeeding.

Effects of maternal Obesity on baby

If you are at pregnancy obesity risk, owing to your weight, then your baby is more likely to have below listed conditions:

• If you are overweight, then there is a chance that the birth happens before 37 completed weeks of pregnancy. This is too soon and can cause severe health problems for babies.
• There are chances that your baby can have congenital disabilities compromising neural tube defects and heart defects. Congenital disabilities can change the shape or function of one or more parts of the body. As a result, they can affect the baby's overall health and development.
• If you have gestational diabetes, your baby may have issues with breathing, low glucose levels, or jaundice.

Myths and truths regarding Obesity and pregnancy

Have you ever tried to know how being overweight affects you during pregnancy? If not, then you will get all the information regarding pregnancy obesity risk, maternal Obesity complicating pregnancy and many other things. Pregnant women are advised by many to eat enough to offer all vital nutrients for their developing baby to help them grow. Almost all women gain weight during pregnancy, but what if they are already obese? Women who are overweight are at high risk of maternal Obesity complicating pregnancy, and their babies are also at risk of many conditions. However, there are many myths and truths linked with Obesity and pregnancy; let us discuss some:

- Obese women are vitamin deficient.

This statement is true as 40 percent of obese women have iron deficiency, 24 percent in folic acid, and about 4 percent in B12. This is the primary matter of concern as some vitamins like folic acid are vital before conception as it lowers the risk of spinal defects and cardiac problems in newborns. In addition, many other vitamins are required throughout pregnancy to help babies grow inside. Therefore, vitamin deficiency in women is associated with their diet and not quantity.

- Obese women need to gain about 15 pounds during pregnancy.

This is a myth as obese women with excessive weight face maternal obesity complicating pregnancy, making them more prone to preterm birth, cesarean delivery, failed labor induction, and low blood sugar levels. The best key is to talk to your doctor regarding this to reduce pregnancy obesity risks and to get appropriate weight gain throughout the process.

- The risk of preterm birth is higher in obese than in non-obese women.

Pregnancy for obese women differs from non-obese women, but this is a myth that the risk of preterm delivery is higher in women with maternal Obesity. But preterm delivery cases are lower in obese than non-obese women, and there is no specific reason for this. However, as per experts, this can be related to hormone changes in obese women that may suddenly reduce the risk of preterm birth.

- Respiratory disease in Obesity increases the risk of maternal Obesity, complicating pregnancy.

This statement is true obese women have increased rates of respiratory complications, and some of them experience asthma during pregnancy. However, women with maternal obesity syndrome are at one and a half times more than non-obese women. The respiratory complication is one of many pregnancy obesity risks women can experience during pregnancy.

- Breastfeeding rates are high in women with maternal obesity syndrome

This is a myth as breastfeeding rates are pretty poor among obese women. As per experts, women with maternal obesity conditions find it more challenging to breastfeed as it takes a long time for their milk to come in. Also, preterm birth can result in the separation of mother and child for more time, and that also affects their breastfeeding.

Maternal obesity – risks and management

As maternal Obesity complicates pregnancy and is a common condition nowadays, all maternity care clinics must help women manage it effectively. Some women experience pre-pregnancy weight gain that elevates the risk of many adverse fetal and maternal outcomes, as discussed above. Pregnancy weight gain also increases the risk of spontaneous and recurrent miscarriages, congenital heart and neural tube defects, wound infections, depression, and many other adverse conditions. Thus weight loss before pregnancy is the most effective way to manage and further reduce the chances of maternal and fetal risks.

FAQs

1. How do you manage weight to avoid maternal obesity risks?

It is important to have a healthy weight during pregnancy to avoid maternal obesity risks and complications. Healthy eating and controlled weight gain are the only keys to managing and attaining healthy pregnancy for obese women. Strong health during pregnancy is good for you and your child's health and also cuts the chances of your child having health issues like diabetes, Obesity, and heart disease at any stage of life. Also remember that you need not lose a lot of weight, you need to maintain a healthy weight, as being underweight can also have its own complications.

2. What to do if you are overweight and want to conceive?

 To avoid pregnancy obesity risk, it is necessary to have a healthy weight range; this will also improve your chances of getting pregnant. It is best to lose some weight before starting to get pregnant. It is best to consult a doctor to know the recommended weight range and reduce a small amount of weight. It will help you a lot to avoid maternal Obesity complicating situations.

3. What to do if in case you are overweight when you get pregnant?

It is best to pay attention to what you eat, how active you are and how much weight you gain during pregnancy. Knowing all these things can help you a lot to stay healthier and to avoid maternal obesity complications.

4. How to deal with postpartum weight?

Pregnancy and childbirth are the two most vital phases of life; however, maternal Obesity is often normalized and accepted, but in some cases, mothers face pressure to lose the weight that they have gained during pregnancy instantly. There should be no rush to get back to pre-pregnancy weight, especially when you are breastfeeding. Mothers need to maintain adequate calories from milk supply, healing, energy as well as nourishment. It is a bit difficult to lose weight after having a baby. There are many reasons, but it is necessary to understand that maternal Obesity does not only include excess fat. After delivery, you lose about 15 pounds of weight, including baby, blood volume, placenta, etc. after losing this weight, you will Ned time to lose the other pounds you gained during pregnancy. Losing fat pounds takes time and commitment. New mothers cannot lose weight instantly, affecting the milk supply. If you are breastfeeding, losing weight can cause a decrease in milk supply. Also, breastfeeding increase your appetite and prevents quick weight loss.

Conclusion :

It is essential to understand that maternal Obesity, if not managed in a better way and at the right time, can lead to gestational diabetes and larger birth weight for the baby. A healthy pregnancy is in which you gain healthy weight. If you need to know the best way to manage weight and maternal pregnancy obesity risk, stay updated and consult your doctor. Also, it is best to consult a doctor if you want to get pregnant and have a BMI above 30; it will help you to stay informed and make appropriate decisions.