Pregnancy Obesity

New research recommends that women who are overweight or obese and preparing for pregnancy should be encouraged to reduce their weight. The research shows an increasing proportion of poor health outcomes for mothers and their children are linked to pregnancy obesity.

Weight gain during pregnancy is normal and how much weight gained will vary with each person. Your doctor will guide you if your weight becomes an issue when pregnant.

This article is about a research study that shows the importance of attaining a healthy weight before getting pregnant and also following-up by maintaining a healthy pregnancy weight.

The Research
Researchers analysed the BMIs, demographic characteristics and health outcomes around the time of birth of 42,582 first-time mothers at Sydney’s Royal Prince Alfred Hospital between 1990 and 2014.

The Results
Researchers found the prevalence of overweight and obese first-time mothers had increased and the number of women within a normal body mass index (BMI) range had fallen.

At the same time, the proportion of poor health outcomes attributable to excessive weight during pregnancy had steadily increased.

They found the number of women who were overweight increased from 12.7 to 16.4 per cent; the prevalence of obesity rose from 4.8 to 7.3 per cent, while the proportion of women in a normal BMI range fell from 73.5 to 68.2 per cent.

‘As a consequence of that, we saw a rise in a whole range of adverse outcomes such as caesarean sections, prematurity, gestational diabetes, stillbirths, foetal abnormality, pre-eclampsia and foetal macrosomia [larger than average baby].

A substantial number of those outcomes could have been avoided with obesity prevention strategies that reduce pre-pregnancy weight Associate Professor Black said.

Associate Professor Kirsten Black also said:
‘Previous efforts to reduce the risks of maternal obesity in pregnant women had failed, and that obesity prevention strategies needed to target women prior to getting pregnant.’

‘The sentiment from nutritionists and obstetricians is that the greatest impact on adverse outcomes will occur if women lose weight before they get pregnant.’

Key points from the study
• The proportion of poor health outcomes for mums and babies linked to maternal obesity is on the rise

• The number of overweight and obese pregnant women has increased in the last 25 years

• Experts are calling for obesity prevention strategies to target women before they fall pregnant

• Maternal complications included pre-eclampsia, gestational diabetes and caesarean birth, as well as complications for the baby, including being large for gestational age.

The Key is Attaining Good Health Before Pregnancy

Associate Professor Black said:
‘Once women are already pregnant it may be too late to reduce the risks of maternal obesity.’

‘There have been a number of studies that have tried to alter the impact of obesity on adverse outcomes in women who are already pregnant, so instituting things like exercise and dietary changes,’ she said.

‘But the results have been disappointing in all those trials… so it’s important women optimise their health before pregnancy.’

In addition to population-wide strategies to reduce obesity, the gynaecologist said health professionals needed to get better at having ‘healthy conversations’ with people about their weight.

Associate Professor Black also said:

‘It’s important so that we can raise the issue in a way that women are able to find their own solutions, they’re not dictated to, and they don’t feel judged.’

‘There are a range of conditions for which women should be advised on around pregnancy … so we need to also ensure that there is greater access to pre-conception care.’

Study – published in the Medical Journal of Australia.