Obesity in Pregnancy
Obesity in pregnancy is when the body mas index is (BMI) 30% or more.
Obesity negative side effects:
A. Before pregnancy:
It might cause:
1. pregnancy delay due to abnormal ovulation.
2. Unsuccessful IVF.
B. During pregnancy:
Increase the Risk of:
1. High blood pressure.
2. Preeclamsia.
3. Heart problems.
4. Preterm birth.
5. Stillbirth.
6. miscarriage due to:
a. hormonal changes related to obesity.
b. Increased risk of PCOS.
6. Gestational diabetes.
7. Sleep apnea.
8. Difficulty in detecting birth defects with ultrasound.
9. Post term pregnancy.
C. On labor and delivery:
Increase the risk of:
1. Longer labor.
2. Longer induction.
3. Induction failure.
4. Cesarean delivery.
5. postpartum haemorrhage.
6. Possible failure of vaginal delivery after the cesarean.
7. Difficulties with anesthesia.
D. On the baby:
Increase the risk of:
1. Larger baby (macrosomia), greater than 4 kg.
2. Congenital anomalies.
3. Possibility of childhood obesity.
4. Asthma.
5. neurodevelopmental and psychiatric disorders.
Special care needed if obese during pregnancy:
1. Early test in the first prenatal visit for glucose level in the blood. Repeat the test in week 24 and 28 of pregnancy.
2. As obesity may cause some limitations, more experienced or specialized fetal ultrasound screening might be needed.
3. Obese pregnant lady (and other risk factors such as first pregnancy, age of more than 35 years, family history of pre-eclampsia) may need a low dose of Aspirin to reduce the risk of preeclamsia. 81 -150 mg aspirin daily from 12 weeks of gestation until delivery.
4. In case of cesarean delivery, the lady might be given an IV single dose of cefazolin (antibiotics) (3 g) to avoid incision infection.
5. Obese pregnant ladies might be given thromboprophylaxis during pregnancy, during and after delivery to avoid the risk of blood clotting.
Average weight gain during pregnancy:
Your weight before pregnancy determines how much weight you can gain safely while pregnant. Consult your doctor.
If you are obese, the average weight you can gain as the following:
Single fetus: about 5 to 9 kilograms.
Multiple: about 11 to 19 kilograms.
Tips:
1. Obese ladies are advised to take 5 mg of folic acid supplements one month before conceiving until the first trimester of pregnancy.
2. If the lady had any bariatric surgery, it is recommended to wait 12 – 18 months before trying pregnancy to allow for stability of body weight and treat any potential problems.
3. The most important thing is to maintain a healthy weight before, during and after pregnancy by a balanced diet and regular exercise.
4. Check with your doctor for any safe exercises to stay active during pregnancy. (15 – 30 minutes three times a week). Other exercises such as swimming, walking and pregnancy yoga.
