Obesity and Pregnancy

Obesity means having an excessive accumulation of body fat that increases the risk for health problems. Body mass index (BMI) is a screening tool healthcare professionals can use to determine a patient’s weight category as underweight, healthy weight, overweight, or obese. BMI is determined by dividing an individual’s weight in kilograms by the square of the individual’s height in meters:

• Underweight: Below 18.5

• Healthy Weight: 18.5–24.9

• Overweight: 25.0–29.9

• Obese: 30 and Above

If a pregnant woman is obese during pregnancy, she is at greater risk for several health conditions and complications, including:

• Gestational Diabetes—Gestational diabetes is a type of diabetes that can occur during pregnancy. If the pancreas fails to keep up with the increased insulin requirements of pregnancy, blood glucose (sugar) becomes too high. Patients at higher risk for gestational diabetes (such as obese patients) may be screened for gestational diabetes at their first prenatal visit. Those at average risk are typically screened for gestational diabetes between 24 and 28 weeks of pregnancy. Mothers who develop gestational diabetes are more likely to develop the condition during subsequent pregnancies and develop type 2 diabetes later in life.

An English/Spanish handout, our Understanding Gestational Diabetes Tear
Pad provides easy-to-understand information about gestational diabetes.

• High Blood Pressure and Preeclampsia—Obesity during pregnancy may be associated with chronic hypertension (high blood pressure that occurs prior to pregnancy or prior to 20 weeks of pregnancy) or gestational hypertension (high blood pressure that occurs after 20 weeks of pregnancy). Both can lead to the development of preeclampsia. Preeclampsia is a condition that usually develops after 20 weeks of pregnancy when a woman has high blood pressure and develops signs that her organs (often the kidneys or liver) are not working properly. If seizures occur, preeclampsia has progressed to eclampsia, which can lead to stroke.

Our High Blood Pressure in Pregnancy Tear Pad
explains the risk factors and signs of preeclampsia.

• Blood Clotting Problems—Obesity during pregnancy can increase the risk of a blood clot breaking from blood vessel walls, potentially leading to a stroke or heart attack.

• Sleep Apnea—Being obese increases the risk of sleep apnea, a condition that stops breathing for short periods during sleep. Excess weight around the neck can narrow the throat’s airway and interrupt breathing. Sleep apnea raises the risk for high blood pressure, preeclampsia, eclampsia, and heart problems.

• Cesarean Delivery—Obesity during pregnanty increases the risk of having a cesarean delivery. Having gestational diabetes or severe preeclampsia can result in the need for a cesarean delivery. Obese women who have cesarean deliveries are more likely to have complications, such as wound infection.

Babies born to mothers who were obese while pregnant are at increased risk of:

• Miscarriage or Stillbirth—Miscarriage is the loss of a fetus before 20 weeks of pregnancy. Stillbirth occurs when the baby dies in the womb after 20 weeks of pregnancy. A higher BMI increases the risk for stillbirth.

• Preterm Birth—A premature birth is a birth that occurs before 37 full weeks of pregnancy. Babies who are born preterm are at risk for serious health problems that may have a lifelong impact.

• Birth Defects—Babies born to mothers who are obese are at increased risk for birth defects, including heart defects and neural tube defects, which affect the brain and spinal cord. Having excess body fat during pregnancy may also make it harder to see and detect issues in a developing baby with ultrasound.

• Large Size—Babies born to mothers who are obese are more likely to be large for their gestational age (macrosomia), which can lead to complications during labor and the need for cesarean delivery. Mothers who develop gestational diabetes are at increased risk for having a large baby. Babies with a high birthweight are at greater risk for developing type 2 diabetes as they get older.

Establishing and maintaining a healthy weight prior to pregnancy can help reduce the chances of any complications before and during childbirth. In addition to regular physical activity, a diet following MyPlate’s nutritional guidelines that focuses on nutrient-dense foods while avoiding foods high in added sugars, sodium, and saturated fats is key to maintaining a healthy weight. A preconception checkup with a healthcare professional can help a woman assess her health status and work toward achieving optimal health prior to becoming pregnant.

Even if a woman is obese, losing just a relatively small amount of weight, such as 10 to 20 pounds or 5 to 7 percent of total body weight, can help prevent obesity-related pregnancy complications. A woman who is obese may still have a healthy pregnancy if she works closely with her healthcare professional, follows her healthcare professional’s guidelines throughout pregnancy, gets all recommended prenatal care and monitoring, and manages her pregnancy weight gain

At Childbirth Graphics, we believe that childbirth education is essential for the best pregnancy outcomes. Discover more of our creative childbirth education materials and models that effectively help teach about healthy prenatal practices as well as labor and delivery in our product sections dedicated to pregnancy, nutrition, pregnancy hazards, and labor and birth.

The information contained in this article is not intended to replace the advice of a healthcare professional.

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