How does obesity affect pregnancy?

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Pham Thi Yen - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital. Doctor has more than 10 years of experience in examination and treatment in the field of Obstetrics and Gynecology.
Obesity during pregnancy greatly affects the health of the pregnant mother, and even carries the risk of serious complications for the fetus. Therefore, pregnant women need to have appropriate methods to avoid obesity during pregnancy, ensuring the health of mother and baby.

1. Obesity during pregnancy

Overweight is defined as when the body mass index (BMI) is between 25 - 29.9. Obesity is a condition that occurs when the BMI is 30 or higher. In developing countries, obesity as well as malnutrition are quite common, concentrated in big cities rather than in rural areas. Vietnam has an average overweight and obesity rate of about 6 - 10%.
Obesity causes many harms to health. Obesity during pregnancy can affect the health of both the mother and the fetus.

2. Effects of obesity during pregnancy

2.1. To pregnant women Being obese during pregnancy puts you at risk for a number of serious health problems:
Gestational diabetes : Diabetes that begins to occur during pregnancy. This condition can put you at risk for a cesarean section. Women with gestational diabetes are also more likely to develop diabetes in the future, and the condition can be passed on to the baby. Obese women during pregnancy must be screened for gestational diabetes at an early stage. Preeclampsia: A disorder related to high blood pressure that occurs during or after pregnancy. This is a dangerous disease that affects the entire body of a woman. Preeclampsia causes kidney and liver failure and can lead to seizures (a condition called eclampsia). Some cases lead to stroke. Severe cases require urgent treatment to avoid these complications. The baby is more likely to be born early. Sleep Apnea: A condition in which breathing stops for a short time during sleep. This phenomenon is related to obesity. During pregnancy, sleep apnea not only causes fatigue, but also increases the risk of high blood pressure, pre-eclampsia, eclampsia, and heart and lung conditions.

2.2. To the fetus Obesity during pregnancy can greatly affect the fetus:
Miscarriage: Obese women have a higher rate of miscarriage than women of normal weight. Birth defects: Babies born to obese mothers are at increased risk for birth defects, such as heart defects or neural tube defects. Difficulty performing diagnostic tests: Too much body fat can make it difficult to diagnose certain problems with your baby's anatomy during an ultrasound. Checking the baby's heart rate during labor is also more difficult when the mother is obese. Macrosomia: In this condition, the baby's body is larger than normal. As a result, there is an increased risk of the baby being harmed during labor. For example, a baby's shoulder may get stuck during birth. Macrosomia can also lead to a woman having a cesarean section. Babies that are too big are more likely to be obese later in life. Preterm birth: Problems associated with obesity during pregnancy, such as preeclampsia, can lead to premature birth. Premature babies often don't develop as fully as babies born after 39 weeks of pregnancy. Stillbirth: The higher the BMI, the higher the risk of stillbirth.

3. Avoid obesity during pregnancy

Losing weight before pregnancy is the best way to avoid the risk of problems caused by obesity. Even losing a small amount of weight (5 - 7% of your current weight) will significantly improve your overall health and better prepare you for a healthy pregnancy.
To lose weight, you need to burn more calories than you consume. Women can effectively lose weight with regular exercise and a healthy diet.
3.1. How much exercise to avoid obesity during pregnancy? Pregnant women need to maintain moderate exercise. However, pregnant women should talk to their obstetrician to plan a safe exercise. Start slowly with 5 minutes of exercise a day and increase it gradually each week. Your goal should be to stick to the routine of exercising for 30 minutes a day, every day of the week if possible. Walking is a good option if you are just starting out with exercise. In addition, swimming is also a very good exercise for pregnant women. When swimming, the water environment will support your body, thus preventing injury and muscle strain.
3.2. Reasonable diet The daily food supplement needs to be reasonable and in moderation so that the body weight does not increase too much. During the second and third trimesters, pregnant women need an average of 300 calories per day, the same amount found in a glass of skim milk and half a sandwich. A scientific diet and regular exercise can partly help you avoid obesity during pregnancy.

3.3. Should I take weight loss pills before getting pregnant? If you've tried to lose weight with dietary changes and exercise, but your BMI remains high of 30 or higher, or over 27 in the presence of certain medical conditions, such as diabetes or heart disease, your doctor may recommend additional weight loss medications. However, these medicines should not be taken if you are trying to get pregnant or are already pregnant.
3.4. Should bariatric surgery be performed before pregnancy? Bariatric surgery may be an appropriate option for people who are very obese or who have serious health problems caused by obesity. If you've had bariatric surgery, you should delay becoming pregnant for 12-24 months after surgery, as that's when your weight will drop the fastest. Certain types of surgery can affect the absorption of oral medications, including oral contraceptives. In this case, you need to switch to another form of contraception.

4. What to do when the obese person is pregnant?

Despite the risks, women who are obese during pregnancy can have healthy pregnancies. However, pregnant women need to see an obstetrician and a dietitian, for a special care plan. Accordingly, pregnant women should be closely monitored for indicators such as blood sugar, blood pressure, liver function, kidney function during pregnancy. The goal is to maintain these indicators within normal limits. Each stage of pregnancy has risks that need to be prevented in advance to avoid complications later.
The first trimester: The possibility of miscarriage is high, the doctor needs to give birth control pills and antispasmodics. The second trimester: The risk of miscarriage is still there, accompanied by pre-eclampsia and gestational diabetes... Attention should be paid to close monitoring and timely treatment. Third trimester: Risk of gestational hypertension, preeclampsia, gestational diabetes, carpal tunnel syndrome during pregnancy, sacroiliac dilatation, and risk of preterm birth. In all cases, women who are obese during pregnancy need to follow their doctor's treatment instructions.

5. How to control weight after giving birth?

Once you are "round and square", practice healthy eating habits and exercise regularly to achieve the desired weight. Breastfeeding is recommended for the first year of a child's life. Breastfeeding is not only the best way to feed your baby, but it also helps with postpartum weight loss. In general, women who breastfeed for at least a few months tend to lose weight faster than women who don't breastfeed.
Thus, obesity has certain effects on pregnancy. Therefore, it is best for pregnant women to plan to lose weight early to avoid obesity during pregnancy in the near future.

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