The Link Between Obesity and Pregnancy Complications

You've heard the staggering statistics: Only about one-third of American women are of a normal weight, while one-third are overweight (meaning they have with a body-mass index, or BMI, of 25 to 30) and one-third are obese (with a BMI greater than 30). With so many women carrying extra pounds, our perception of normal weight has been so dramatically skewed that many health providers don't even notice when a woman is overweight. This carries many increased risks.

The consequences of obesity in non-pregnant women are well-known—diabetes, high blood pressure, stroke, certain cancers, joint problems and liver and gallbladder disease.

And now the health risks of obesity during pregnancy are clear as well.

How being overweight or obese puts your pregnancy—and your life—at risk.

Diabetes
An overweight mother is four times more likely to develop gestational diabetes. This can lead to extremely large infants who are more likely to have birth injuries or require Caesarean delivery.

Preeclampsia
Obese mothers are twice as likely to have high blood pressure related to pregnancy. This can increase the chance of blood clots, stroke and premature birth.

Higher Chance of Caesarean
When delivering a baby naturally, my medical partners and I like to say, "It's all about the push." Women who are carrying extra weight, especially in the midsection, have less muscle tone and thus less strength with which to push their babies out. In addition, the extra fat deposits within the birth canal make it much more difficult for the baby to slip through.

Do you want to avoid a C-section? Maintaining a healthy weight is high on the list of the best ways to do it.

• For women of normal weight, the C-section rate is 11 percent.
• For overweight women, it increases to 18 percent.
• For obese women, it jumps to 43 percent.

In addition, obese women who have a Caesarean have a higher risk of blood clots, bleeding and infections after surgery.

Higher Risk of Birth Defects
In obese women, the risk of spina bifida is twice that seen in normal-weight women. The risk for cleft lip is 20 percent higher, the risk for heart defects is 30 percent higher, and the risk for hydrocephalus is 60 percent higher.

Inability to Detect Birth Defects
Ultrasound is our best tool in obstetrics, yet this technology is limited by the distance the sound waves need to travel. For overweight women, 3 or more inches of fat on the abdominal wall can limit the detail of what we can see, leaving us unable to detect some subtle birth defects.

Pregnancy Symptoms
Even the more mundane symptoms and discomforts of pregnancy occur far more often in obese mothers. These include heartburn, carpal tunnel syndrome, back pain, pelvic pressure and headaches.

Maternal Mortality
Public health officials have reported that the maternal mortality rate in the United States has been on the rise in recent years. A major contributing factor in this shocking trend is the increase in obesity rates. Of all maternal deaths, two-thirds are related to complications of obesity.

It is clear that one of the best things you can do prior to getting pregnant is getting your body to its healthiest weight. Calculate your BMI—many women are not even sure where they stand. Then talk to your doctor about a weight loss plan before putting yourself and your baby at unintended risk.

Dr. Yvonne Bohn, Dr. Allison Hill and Dr. Alane Park are the Mommy Docs. While they are doctors, they're also moms with six kids among them. They've welcomed more than 15,000 babies into the world. The Mommy Docs are featured in the TV series Deliver Me on the Discovery Health Channel. For more information on the Mommy Docs, visit MommyDocs.com.

Do you have a question for the Mommy Docs? Share your question or comment below.

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