Obesity is a recent epidemic. In the UK, one out of five antenatal women is obese. In the USA 60% adults are obese now. In this perspective, obesity is now considered as an important health problem. Pregnancies are often complicated by obesity as obese gravid women develop pregnancy complications at a faster rate than the non-obese.
But How Do You Know Whether You Are Obese or Not?
A generalized definition of obesity is if your BMI is >30kg/m2. BMI is the abbreviated form of body mass index. It is calculated as body weight in Kg/ body surface area in m2.
Typical body surface area[BSA] for a newborn is 0.25 m2, child of 2 years old 0.5 m2, child of 10 years old 1.14 m2, adult women 1.6 m2, adult man 1.9 m2. You can get it also by putting your dimensions in a computation. i.e. www.calculator.net.
Obesity and Pregnancy Risks
Obesity acts as a barrier to fertility. You may have to stumble upon infertility and abortions if you are obese. More over these complications are significantly increased if you particularly have central obesity, i.e. significant fat deposition around your waist.
Major maternal complications associated with obesity in pregnancy are many fold. Apart from suffering from all aggravated minor ailments of pregnancy; you are prone to the followings
Respiratory disorders and
Obese women face more difficulties in labor in comparison to non obese women. Directly they face a higher risk of caesarean section and difficult vaginal deliveries. Obese women deliver big babies and this fact is responsible for these obstetric complications. Incidences of postpartum complications like hemorrhage and failure to initiate lactation are higher in obese women.
Fetal Complications in Obese Pregnant Women
Big baby is a consequence of maternal obesity. This is not always favorable as higher birth weight is a risk factor for adolescent/adult obesity. The chances of intrauterine death and having a congenital defect called neural tube defect are higher in pregnancy with obesity.
Managing Obesity Beforehand – Needs Preconceptional Counseling
There are lots of modalities available for reducing weight. Nutritional education, lifestyle modification, drug treatment and dieting are the options available in reducing weight in the preconception period. But results vary widely as these modalities are entirely receiver dependent. Bariatric surgery is a recent advance and is recommended for women with BMI>40 kg/m2. In this surgery, part of the stomach has been excised so that dietary absorption and hence weight gain are less. Pregnancy following bariatric surgery appears to have no additional risk.
How much obese, you may be; you should not indulge into dieting and lose weight during pregnancy. You should jolly well gain 7-11 kg throughout the pregnancy.
Exercises, especially light exercises, are recommended provided you do not have any other complicating factors. Regular exercise helps to prevent development of complications. But morbidly obese women should not indulge into exercise in pregnancy.