Obesity During Pregnancy

Wondering how obesity affects pregnancy? We've got answers.
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By Jennifer L.W. Fink, Registered Nurse
Updated February 28, 2017
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What is obesity during pregnancy?

Obesity is officially defined as a body mass index (BMI) of 30 or above. BMI is a measure of your height and weight to estimate the amount of fat on your body. The higher your BMI, the more body fat you typically have.

What are the signs of obesity during pregnancy?

In some cases, it can be hard to tell the difference between “a few extra pounds” and “obesity.” Appearance isn’t always the best indicator of health or obesity, but visible excess body fat can be one clue. Your doctor can help you figure out if you’re carrying too much extra weight.

Are there any tests for obesity during pregnancy?

BMI is a good starting point, but it doesn’t actually tell the full story. That’s because BMI is an estimation of body fat based on a person’s height and weight — for example, a 6-foot-tall, 230-pound NFL lineman probably has less body fat than a 6-foot-tall, 230-pound armchair quarterback of a husband. That’s why some health care providers will use other measures, like waist circumference (which doesn’t always work so well in pregnancy!) or skinfold tests, to estimate body fat.

How common is obesity during pregnancy?

More common than you might think. About one in four women of childbearing age are obese.

How did I get obese?

While many people are quick to blame obesity on poor eating habits and lack of exercise, the fact is, a wide variety of factors, including stress, metabolism and genetic history, influence a woman’s weight.

How will my obesity affect my baby?

“One of the major concerns with obesity in pregnant women is that the risk of stillbirth is doubled in women with BMIs over 30. The risk goes from 1 in 1,000 to 1 in 500,” says Rebecca Kolp, MD, an ob-gyn at Massachusetts General Hospital.

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Maternal obesity also increases the risk of birth defects. Babies of obese moms have twice the risk of neural tube defects, a 30 percent greater risk of heart defects, a 20 percent greater risk of cleft lip or palate, a 60 percent greater risk of fluid in the brain and a 30 percent increased risk of problems with arm and leg development.
Obesity increases your risk of developing  gestational diabetes and/or high blood pressure and  preeclampsia during pregnancy — conditions that can cause problems for you and for baby.

Obesity also increases risks at birth. Obese moms are more likely to deliver larger babies and more likely to need a  c-section or other interventions during birth. (See next page for info on treating your obesity during pregnancy.)

What’s the best way to treat obesity during pregnancy?

Focus on keeping your weight in check. “The weight-gain goals for someone who is obese are to gain less pregnancy weight than someone who’s not obese,” Kolp says. Nonobese pregnant women are generally advised to gain 25 to 35 pounds; obese pregnant women should try to keep that number between 11 and 20 pounds, a goal that Kolp says “is very possible and reasonable to achieve.”

Work with your physician — and a nutritionist, if needed — to develop a healthy eating plan for pregnancy. Cut out the junk food and stick to  healthy, nutrient-dense foods like nuts and whole grains. Make sure you  exercise throughout your pregnancy too. Pregnancy isn’t the time to start a new, strenuous workout, but almost everyone can manage walks around the block.

What can I do to prevent complications from obesity?

Follow your doctor’s recommendations regarding diet, exercise and prenatal testing. Obesity raises the risk of gestational diabetes and high blood pressure, so your doc will be checking your glucose levels and blood pressure throughout the pregnancy. He may also order fetal testing toward the end of your pregnancy to see how your baby is doing. If your baby isn’t doing well, an  early delivery might be ordered.

Are there any other resources for obesity during pregnancy?

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