Obesity in pregnancy: pre-conceptional to postpartum consequences

J Obstet Gynaecol Can. 2008 Jun;30(6):477-488. doi: 10.1016/S1701-2163(16)32863-8.

Abstract

Objective: To review the effects of obesity on reproduction and pregnancy outcome.

Methods: A search of the literature was performed using key word searching and citation snowballing to identify English language articles published between January 1, 2000, and December 31, 2006, on the subject of obesity and its effects on pregnancy. Once the articles were identified, a thorough review of all results was conducted. Results and conclusions were compiled and summarized.

Results: Obesity during pregnancy was linked with maternal complications ranging from effects on fertility to effects on delivery and in the postpartum period, as well as many complications affecting the fetus and newborn. The maternal complications associated with obesity included increased risks of infertility, hypertensive disorders, gestational diabetes mellitus, and delivery by Caesarean section. Fetal complications included increased risks of macrosomia, intrauterine fetal death and stillbirth, and admission to the neonatal intensive care unit.

Conclusion: Obesity causes significant complications for the mother and fetus. Interventions directed towards weight loss and prevention of excessive weight gain must begin in the pre-conception period. Obstetrical care providers must counsel their obese patients regarding the risks and complications conferred by obesity and the importance of weight loss. Maternal and fetal surveillance may need to be heightened during pregnancy; a multidisciplinary approach is useful. Women need to be informed about both maternal and fetal complications and about the measures that are necessary to optimize outcome, but the most important measure is to address the issue of weight prior to pregnancy.

Publication types

  • Review

MeSH terms

  • Adult
  • Female
  • Fetal Death / etiology
  • Humans
  • Hypertension, Pregnancy-Induced / epidemiology
  • Hypertension, Pregnancy-Induced / etiology
  • Obesity / complications*
  • Obesity / epidemiology
  • Postpartum Period
  • Preconception Care
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / etiology
  • Pregnancy Outcome* / epidemiology
  • Pregnancy in Diabetics / epidemiology
  • Pregnancy in Diabetics / etiology
  • Reproduction / physiology*
  • Risk Factors
  • Weight Loss / physiology*