Obesity Complicates Pregnancy

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In developed countries maternal obesity is one of the underlying risk factors for maternal mortality.
Obesity and weight gain (excessive) during pregnancy are associated with following risk factors:

  • Cardiovascular diseases
  • Metabolic diseases
  • Increased risk of obesity in the child

Obese health care women need much more health care and this will result in economic implications.
The interventions to treat obesity during pregnancy lack definite data to prove their efficacy.

Effect of Maternal health:

Medical Disorders during pregnancy:
Maternal mortality is greatly associated with obesity. It is related to a wide range of maternal medical problems like

  • Type 2 diabetes
  • Gestational diabetes mellitus
  • Pre-eclampsia
  • Thromboembolic disease
  • Obstructive sleep apnea
  • Asthma
  • Cholecystitis
  • Prenatal and Post Partum issues:
  • Increasing obesity is proportional to post partum haemorrhage and subsequent postpartum anaemia.
  • Typical peripartum infections:
  • Post caesarean section wound infections
  • Chest infections
  • Genital tract infections
  • Pyrexia
  • Urinary Tractinfections
  • Lactation failure
  • Delay in establishing lactation post delivery. This occurs because of the abnormal prolactin response.

A high BMI will increase the risk of interference during delivery. They are less likely to get spontaneous onset of labour. They will require induction of labour.

With increase in the BMI rate of caesarean section and the operative and complicated vaginal delivery rates increase.

The anaesthesia requirement also increases. This again increases the risk of maternal mortality.

Neonatal Outcomes:

Antepartum stillbirth:
The biological pathway underlying the stillbirth is still not clear. It may be due to maternal complications occurring due to obesity which includes hypertensive disorders of pregnancy and gestational diabetes.

Perinatal Morbidity:
Neonates born to mothers with obesity are at comparatively high risk of meconium aspiration and shoulder dystocia.

Birth defects:
Some defects associated with maternal obesity includes

  • Neural tube defects,
  • Cardiac defects,
  • Intestinal tract abnormalities,
  • Omhalocoeles,
  • Orofacial clefts and
  • Multiple congenital anomalies of CNS

Childhood Obesity:
Maternal obesity and fetal overnutrition acts as a precursor to the development of childhood obesity.
The infants with higher birth weight face high risk of obesity throughout adolescence and adulthood.
Infants born to mothers with obesity are likely to possess more total and relative fat mass and less fat-free mass.

This blog doesnot contain any plagiarised material5,6

References:

  1. Ingrid Rowlands, Nick Graves, Susan de Jersey, H. David McIntyre, Leonie Callaway ;" Obesity in pregnancy: outcomes and economics" Seminars in Fetal & Neonatal Medicine 15 (2010) 94-99. {Accessed on June 3rd 2010}
  2. Cecilia Jevitt, Pregnancy Complicated by Obesity: Midwifery Management; J Midwifery Womens Health 2009;54:445-451 {Accessed on June 6th 2010}
  3. Rekha Wuntakal, Tony Hollingworth; The implications of obesity on pregnancy; OBSTETRICS, GYNAECOLOGY AND REPRODUCTIVE MEDICINE 19:12 {Accessed on June 7th 2010}
  4. Medical Conditions Affecting Pregnancy and Childbirth; Judy Bothamley, Maureen Boyle; Radcliffe Publishers. pages-238,240-244,257 {Accessed on June 10th 2010}
  5. http://www.dustball.com/cs/plagiarism.checker/ {Accessed on June 15th 2010}
  6. http://www.articlechecker.com/checker.php {Accessed on June 15th 2010}
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About the Author

Aparna Sannapu's picture
Author: Aparna Sannapu

Comments

Siva Mavuduru's picture

Hi Aparna I had a small doubt there will be increase in BMI when the muscle mass is more. Will that cause these same problems what you described above?

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