The consequences of obesity and excess weight gain in pregnancy

Jane E. Norman, Rebecca M. Reynolds

Research output: Contribution to journalArticle (Academic Journal)

Abstract

The prevalence of obesity in pregnancy is rising exponentially; about 15-20% of pregnant women now enter pregnancy with a BMI which would define them as obese. This paper provides a review of the strong links between obesity and adverse pregnancy outcome which operate across a range of pregnancy complications. For example, obesity is associated with an increased risk of maternal mortality, gestational diabetes mellitus, thromboembolism, pre-eclampsia and postpartum haemorrhage. Obesity also complicates operative delivery; it makes operative delivery more difficult, increases complications and paradoxically increases the need for operative delivery. The risk of the majority of these complications is amplified by excess weight gain in pregnancy and increases in proportion to the degree of obesity, for example, women with extreme obesity have OR of 7·89 for gestational diabetes and 3·84 for postpartum haemorrhage compared to their lean counterparts. The consequences of maternal obesity do not stop once the baby is born. Maternal obesity programmes a variety of long-term adverse outcomes, including obesity in the offspring at adulthood. Such an effect is mediated at least in part via high birthweight; a recent study has suggested that the odds of adult obesity are two-fold greater in babies weighing more than 4 kg at birth. The mechanism by which obesity causes adverse pregnancy outcome is uncertain. This paper reviews the emerging evidence that hyperglycaemia and insulin resistance may both play a role: the links between hyperglycaemia in pregnancy and both increased birthweight and insulin resistance have been demonstrated in two large studies. Lastly, we discuss the nature and rationale for possible intervention strategies in obese pregnant women.
Original languageEnglish
Pages (from-to)450-456
Number of pages7
JournalProceedings of the Nutrition Society
Volume70
Issue number4
DOIs
Publication statusPublished - 2011

Bibliographical note

RIS file

Keywords

  • Birth Weight Delivery, Obstetric Female Humans Hyperglycemia/complications Insulin Resistance Obesity/complications Obesity/epidemiology Obesity/therapy Pregnancy Pregnancy Complications Pregnancy Outcome Weight Gain

Fingerprint Dive into the research topics of 'The consequences of obesity and excess weight gain in pregnancy'. Together they form a unique fingerprint.

Cite this