The #1 Pregnancy Risk

What’s the leading threat to a healthy pregnancy? Most doctors automatically classify a pregnancy as “high risk” if the woman is over 35—even if she’s in perfect health. However, the risk of most complications only increases slightly with age. A new study suggests that the number ob/gyns should be looking at to gauge risk isn’t age, but a woman’s weight. In March, British researchers reported that being seriously overweight magnifies dangers for both the woman and her unborn child, but little is being done to help obese mothers-to-be.

Maternal obesity has more than doubled over the past 20 years, with one in six pregnant women in the UK facing extra hazards, including heart disease and increased risk of birth defects or stillbirth. More than half of women who die during pregnancy and childbirth are overweight, yet obese women rarely receive any weight management services or support to help them achieve a healthy weight before becoming pregnant or counseling on what they can do to lower risks after they’re already pregnant. 

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In the US, where one in three women are obese, “there are now medical centers specializing in treating morbidly obese pregnant women, with equipment designed for their needs, such as larger, sturdier operating beds, because these patients have a higher rate of C-sections,” says Jennifer Wu, MD, an ob/gyn at Lenox Hill Hospital in New York City. For example, St. Louis University’s SLUCare Pregnancy Bariatric Clinic is targeted to moms-to-be with a BMI of 45 or above (a weight of 280 pounds or more for a 5’ 4” woman.)

Here’s a look at how obesity can impact pregnancy—and steps to protect yourself.

Infertility. It’s harder for heavy women to get pregnant in the first place. To evaluate your weight, use a BMI calculator. If you’re BMI is 25 to 29, you’re overweight and if it is 30 or above, you are obese. Slimming down can not only increase your fertility, but is also the single most important way to ensure a healthy pregnancy, says Dr. Wu. Ask your doctor to refer you to a nutritionist for help in getting the pounds off.

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Gestational diabetes. This temporary form of diabetes that only occurs during pregnancy is more likely to strike overweight or obese women—and if untreated, can have a lasting effect on the baby. Women with this disorder are nearly twice as likely to bear children who become obese than are those with normal blood sugar readings during pregnancy, according to a study by Kaiser Permanente. The researchers report that treating the disease, which can be detected through a blood test, can protect both moms and babies.

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Pre-eclampsisa. Thousands of pregnant women and babies become very ill or even die from this potentially life-threatening pregnancy disorder that can lead to seizure, stroke or multi-organ failure for the mom or baby. Symptoms of the condition, which is more likely to strike overweight or obese women, include high blood pressure, sudden swelling, and protein in the urine. It is also more common in expectant moms over 35 and those of any age who are carrying twins. Pregnant women should have their blood pressure and urine checked at every prenatal visit and alert their ob/gyn if they notice sudden swelling. In the future, a new test may improve diagnosis of the disorder, which occurs in up to 8 percent of pregnancies.

Birth defects. Heavy moms-to-be are nearly twice as likely to have babies with neural tube disorders like spina bifida; risk for heart abnormalities and cleft palate or lip is also increased, reports a recent study. However, the risk is still very low, since only 2 to 5 percent of newborns have birth defects. Taking folic acid, starting at least one month before conception and continuing through the first trimester, lowers the risk of neural tube defects and possibly other defects. However, the study highlights the importance of losing weight before pregnancy if you are overweight or obese, says Dr. Wu.

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