Moms obesity makes gestation more dangerous and expensive

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It s not a new finding that obesity among pregnant women can adversely affect the health of both mom and baby. But the risk of adverse effects such as hypertension, gestational diabetes, and emergency C-section may be much larger than previously thought, according to a study in BJOG: An International Journal of Obstetrics and Gynaecology.

Dr. Fiona C. Denison and colleagues from the University of Edinburgh analyzed data from nearly 110,000 Scottish women. The data included the outcomes of over 124,000 singleton deliveries from women who had their BMI (a standardized measure of body mass calculated using height and weight) recorded before 4 months of pregnancy.

They then compared the risks of several negative outcomes between women who had normal BMIs with those who were underweight, overweight, obese or severely obese. They found that compared to normal weight women, the overweight, obese and severely obese women had risks of 76, 298, and 448 percent for pregnancy-induced hypertension, respectively. Similarly, the risks for gestational diabetes (GDM) were 339, 1190, and 6740 percent (meaning that overweight women had a 3 ½ fold increased risk for GDM, obese women had over a 10-fold increased risk, and severely obese women had an astounding 67-fold higher risk) for GDM, respectively, compared to normal weight women. These groups also had elevated risks for emergency cesarean sections of 94, 340 and 1434 percent respectively.

Not only were these health risks elevated, but as might be expected, the health care costs were also significantly greater. The additional costs for overweight, obese and severely obese women were approximately $96, $323, and $560 respectively, compared to costs for normal weight women.

What can be done to ameliorate these effects? Clearly, if excess body weight is causal, it would be important for women to strive for a normal weight before pregnancy, as dietary restriction during pregnancy is typically not recommended. Regular exercise, established before pregnancy, could also help attain a better weight profile. Indeed, some women who are active before pregnancy maintain their activity during gestation sometimes even at extreme levels. For example, one woman who had been a bodybuilder before pregnancy has recently made the news by continuing her weight-lifting during gestation.

ACSH s Dr. Ruth Kava commented Although this was a retrospective study, and thus can t prove causation, the large sample size, the magnitude of the elevated health risks, and the trends towards greater risks with increasing BMI means that the results of this study should be taken seriously. While few would recommend weight-lifting for pregnant women, moderate exercise before and during gestation should help women attain and maintain a normal BMI. Exercise has many health benefits aside from helping with weight control, and women who are planning a pregnancy should take advantage of a regular exercise routine.