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.
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.
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.
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.