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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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