Updated: September 7, 2017
Obesity has increased significantly in the United States over the last several decades. This has been true across all age groups including women of reproductive age. Over 30% of reproductive age women are obese (as defined by a BMI or body mass index of >30) and almost 60% are overweight or obese (as defined by a BMI of >25). Obesity increases many health risks, including pregnancy related risks for the mother and fetus.
Mothers who are obese have an increased risk for miscarriage, gestational diabetes, high blood pressure and pre-eclampsia, prolonged labors and cesarean section. They are also at increased risk for postpartum infections and blood clots in their legs. Babies have an increased risk for stillbirth, birth defects, prematurity and being born large for gestational age (LGA) which can increase the risk for birth injury.
What can we do to decrease these risks? The best place to start is to lose weight prior to pregnancy. Scheduling an appointment prior to pregnancy to discuss these issues is a great idea. Regular exercise and possibly help from a trainer is important as is a healthy diet. An appointment with a nutritionist can be very helpful. Even modest weight reductions can decrease the risks discussed here.
During pregnancy, a healthy diet and regular exercise continue to be very important to control weight gain. Again, working with a nutritionist can help set a clear plan during pregnancy. Only very small increases in calories are needed for healthy pregnancy. Information about nutrition during pregnancy can also be found here: nutrition during pregnancy. Recommended weight gain during pregnancy should be reviewed and goals set.
The recommended weight gain in pregnancy changes based on the pre-pregnancy BMI:
BMI < 18.5 (underweight) 28-40 lbs.
BMI 18.5-24.9 25-35 lbs.
BMI 25-29.9 15-25 lbs.
BMI >30 11-20 lbs.
If you have concerns about your weight prior to, or during, pregnancy, make an appointment to discuss this with your provider. There is also more information available here: obesity and pregnancy.