|
Heavy Women Who
Become
Pregnant Face Greater Health Risks
There are new reasons to control
your weight both before and after you conceive -- particularly
if you're heavy before you even try to have a baby.
Obesity promotes not only severe
pregnancy complications in the mother, it also places the baby
at high risk of health problems, including an increased chance
of neonatal death.
That's the sobering news from a
group of Swedish researchers who say that not only is it important
to control weight gain during pregnancy, but to also get your
level of body fat under control before you attempt to conceive.
"[We are hopeful] that knowing
the problems concerning pregnancy and delivery associated with
obesity could possibly motivate young women to prevent excessive
weight gain," says study author Dr. Marie Cendergren. She is an
obstetrician in the division of obstetrics and gynecology at Linkoping
University, where the research was conducted.
The findings appear in the February
issue of Obstetrics and Gynecology.
Although Cendergren believes that
reaching as close to a "normal" weight as possible before conception
is the best way to avoid problems, she acknowledges this would
be difficult for most women suffering from obesity.
However she adds that "a BMI below
30 significantly reduces risks," and she encourages women to aim
for that goal. A BMI, or body mass index, is an indication of
the level of body fat. A "normal" BMI ranges from 19 to 26, depending
on height, Cendergren says.
Among the pregnancy problems cited
by the study was an increased risk of preeclampsia, a potentially
fatal form of maternal high blood pressure. Other problems include
increased likelihood of Caesarean-section delivery; greater risk
of shoulder dystocia (damage to the baby's arm and shoulder during
delivery); fetal distress; stillbirth; and death of the child
shortly after birth.
Although losing weight before pregnancy
would help reduce the risk of all these problems, Cendergren suggests
that for even greater insurance, all obese women should be under
the care of a high-risk pregnancy expert.
"We must look upon these pregnancies
and deliveries as high-risk pregnancies -- particularly the doctors
dealing with them," Cendergren says.
New York University obstetrician
Dr. Michael Silverstein says the study underscores the importance
of watching your weight both before and after pregnancy. But,
he adds, this is information most physicians have known for a
long time.
"Whether the weight gain occurs
before pregnancy or after conception takes place, if you are very
overweight it is going to cause a litany of problems affecting
both the mother and the baby," Silverstein says. Even something
as routine as a pregnancy ultrasound -- to check for fetal growth
and development -- can be difficult or impossible to accurately
read when the mother is very overweight.
"I'm not certain if the excess
weight is causing these birthing complications, or if the weight
is keeping us from properly diagnosing certain conditions that
we might otherwise normally see -- particularly those involving
fetal distress," Silverstein says.
While he agrees that some obese
women do require the care of a high-risk pregnancy expert, he
also believes every pregnancy should be viewed in an individual
light.
"A lot depends on the overall health
of the mother. A very overweight woman who is in good physical
condition may be of less concern than a woman who is moderately
overweight but is in poor physical condition or is carrying more
than one baby," he says.
The Swedish study looked at nearly
3,500 pregnancies in morbidly obese women -- defined as a body
mass index over 40. An additional 12,698 women with a BMI between
35.1 and 40 were also part of the study. All were compared to
pregnant women with a normal BMI, falling between 19.8 and 26.
The result: Women with a BMI greater
than 40 were at significantly heightened risk for preeclampsia;
stillbirth; Caesarean delivery; instrument delivery, (such as
forceps); shoulder dystocia; meconium aspiration (a newborn breathing-related
procedure), fetal distress; early neonatal death; and large-for-gestational-age
-- a problem that can lead to other birth complications.
Although women with a BMI between
35.1 and 40 also were subjected to the same risks, the incidence
was notably lower. Indeed, researchers say the lower a woman's
BMI, even by just a few points, the lower her risk of problems.
According to Cendergren, the risk
of gaining excessive amounts of weight during pregnancy is as
detrimental as being very overweight going into the pregnancy.
More information
To learn more about obesity and
pregnancy, visit The
March of Dimes. Or visit the National
Heart, Lung, and Blood Institute for the very latest guidelines
on controlling obesity.
Reference
Source 101
For more information on how to prevent other diseases, use
PreventDisease.com's "Quick
Prevention Resources".
|
