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Obesity Among Pregnant
Women on the Rise

NEW YORK (Reuters Health) - Obesity is on the rise among pregnant women, threatening the health of both mother and child, a recent study suggests.

"The heavier the pregnant woman is, the more common the health risks become...beginning at 200 pounds and over," said study lead author Dr. Hugh M. Ehrenberg of the Case Western Reserve University School of Medicine in Cleveland, Ohio. "So even the mildly obese woman is at an elevated risk."

The authors defined obesity as a weight of more than 200 pounds.

Ehrenberg and his colleagues compared obesity rates among two groups of women who delivered babies in the Cleveland vicinity--more than 31,000 who gave birth between 1986 and 1997 and over 15,000 women who delivered between 1997 and 2001.

The researchers noted the mothers' weight on the day of birth and tracked pregnancy-related health problems before and after delivery.

In the November issue of the American Journal of Obstetrics and Gynecology, the authors report that obesity rates had significantly increased over the study period.

When comparing rates of obesity before and after 1997, Ehrenberg and his team found that the risk for maternal obesity jumped 42% among African-American women, 29% among white women and 26% among Hispanic women. Asian women bucked the trend, being almost 40% less likely to be obese post-1997.

Just over 1% of the women studied fell into the category of "extreme obesity," meaning they weighed over 300 pounds, the researchers note. A further 17% were "moderately obese," weighing from 201 to 250 pounds, and just over 4% were categorized as "severely obese"--weighing between 251 and 300 pounds.

The researchers suggested that even at low levels the rise in maternal obesity--reflective of a rise in US obesity levels overall--is a serious public health concern because of the potential risks to expectant mothers.

For example, Ehrenberg and his colleagues found that moderately obese women were at increased risk for developing a serious high-blood pressure condition known as preeclampsia.

Preeclampsia--which affects 5% of all pregnant women--can cause extreme swelling in the mother's face and hands, and is associated with an increased likelihood that an infant will develop health problems shortly after birth. Also, in some women, preeclampsia progresses to eclampsia, which involves potentially life-threatening seizures during and after childbirth.

In addition, the researchers noted that crossing the 200-pound obesity threshold placed pregnant women at an increased risk for diabetes, carrying their child for an unusually long term, delivering an abnormally large child and having to deliver by cesarean section.

Ehrenberg and his team suggested that women could benefit from physician counseling--both before and after becoming pregnant--about the risks posed by even mild forms of obesity.

"Controlling weight while not pregnant is the first step toward avoiding these complications," Ehrenberg told Reuters Health. "And even if a woman loses weight between pregnancies, during the second pregnancy she'll do better."

Ehrenberg added that he is now examining the potential benefits of embarking on a weight-loss program during pregnancy--an intervention he predicts can be both safe and helpful.

"Common teaching is that weight-loss during pregnancy is bad for the fetus," he admitted. "But that research has been done in women who are already at ideal weight, largely. And given that 70% of pregnancies are unplanned, you're always missing 7 out of 10 women for pre-pregnancy counseling...There's got to be something to do to help them."

SOURCE: American Journal of Obstetrics and Gynecology 2002;187:1189-1192.

Reference Source 89


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