Obesity and Pregnancy

Obesity negatively impacts the health of women in many ways. Being overweight or obese increases the relative risk of diabetes and coronary artery disease in women. Women who are obese have a higher risk of low back pain and knee osteoarthritis. Obesity negatively affects both contraception and fertility as well. Maternal obesity is linked with higher rates of cesarean section as well as higher rates of high-risk obstetrical conditions such as diabetes and hypertension. Pregnancy outcomes are negatively affected by maternal obesity (increased risk of neonatal mortality and malformations). Maternal obesity is associated with a decreased intention to breastfeed, decreased initiation of breastfeeding, and decreased duration of breastfeeding. There seems to be an association between obesity and depression in women, though cultural factors may influence this association. Obese women are at higher risk for multiple cancers, including endometrial cancer, cervical cancer, breast cancer, and perhaps ovarian cancer. The prevalence of obesity is rising. The World Health Organization estimates that more than 1 billion people are overweight, with 300 million meeting the criteria for obesity. Twenty-six percent of non-pregnant women ages 20 to 39 are overweight and 29% are obese.

The risk of diabetes mellitus (DM) increases with the degree and duration of being overweight or obese and with a more central or visceral distribution of body fat. Increased visceral fat enhances the degree of insulin resistance associated with obesity. In turn, insulin resistance and increased visceral fat are the hallmarks of metabolic syndrome, an assembly of risk factors for developing diabetes and cardiovascular disease

An Australian study of more than 14,000 pregnant women found that 34% were overweight, obese, or morbidly obese. In a US study of 9 states that included more than 66,000 women, there was a 22% rate of obesity among pregnant women in 2002 to 2003, which was up 69% since 1993.51 The subgroups of women with the highest increases in obesity rates were women aged 20 to 29 years, were African American, who had ≥3 children, and who were enrolled in the US Department of Agriculture's Women, Infants, and Children program. Obesity causes pregnancy complications because of elevated risks of antepartum complications and mechanical difficulties with delivery.

Obesity during pregnancy is related to higher overall health care expenditures, measured by length of stay after delivery and use of other services. The majority of this difference is caused by higher cesarean section rates and higher rates of high-risk obstetric conditions such as diabetes and hypertension. The mean length of stay after delivery was directly correlated to BMI (3.6-day stay for women with a normal BMI vs 4.4-day stay for women with a BMI >40.0).

Journal of Women’s Health and Reproductive Medicine is an interdisciplinary journal that explores clinical, medical, social and economic aspects of female reproductive health and medication worldwide.

Authors can submit manuscript as an e-mail attachment to the Editorial Office at https://www.imedpub.com/submissions/womens-health-reproductive-medicine.html

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John Kimberly
Associate Managing Editor
Journal of Women’s Health and Reproductive Medicine
Email: womenshealth@emedscholar.com