Obesity in Pregnancy
Potential Issues Associated With Obesity in Pregnancy
During pregnancy
- Increased risk of early pregnancy loss ( miscarriage)
- Type 2 diabetes
- Gestational diabetes
- Pregnancy associated hypertension
- Preeclampsia
- Preterm birth — planned preterm birth is usually occurs because of the present of complications such as high blood pressure. However, there may also be an increase in spontaneous preterm birth.
- Post-term pregnancy
- Multiple pregnancy — there is an increased incidence of fraternal ( non identical) twins
- Obstructive sleep apnea — may be precipitated or exacerbated during pregnancy and may increase the risk for preeclampsia and gestational diabetes
- Carpal tunnel syndrome
During labour
- Induction of labour more likely due to increased risk of pregnancy complications
- Failure of induction of labour is more likely
- Slow first stage of labor (The duration of the second stage of labor does not appear to be affected by increasing BMI)
- Increased dysfunctional labor leading to operative intervention (forceps or vacuum vaginal delivery, cesarean delivery), vaginal laceration
- Cesarean delivery more likely— both elective and emergency cesarean delivery
- Trial of labor after cesarean delivery is less likely to result in vaginal birth
- Difficult anesthesic with higher rates of multiple attempts at epidural placement and failed analgesia requiring a repeat procedure
- Increased risk factor for shoulder dystocia.
Post Delivery
- Blood clotting disorders
- Infection (wound, episiotomy, uterus), regardless of mode of delivery Postpartum depression
Offspring
- Increased risk of birth defects including spinal defects, cardiac abnormalities, facial clefts, and limb abnormalities
- Shoulder dystocia
- Asthma
- Childhood obesity and obesity in later life
Prepregnancy weight loss — a weight reduction program using changes to diet, exercise, and possibly additional medical therapy or surgery, before attempting to conceive appears to have beneficial effects on reproductive function, pregnancy outcome, and overall health . However, note, almost all drugs prescribed for weight reduction have adverse fetal effects and should not be used during pregnancy.
