Impact of maternal obesity on pregnancy course and maternal and perinatal complications
Keywords:
obesity, pre-pregnancy obesity, excessive gestational weight gain, pregnancy risk factors, pregnancy complications
Abstract
The prevalence of obesity and obesity-related health problems is increasing worldwide, especially among woman and man of reproductive age and obesity is designated as one of the most important global health threats in 21st century. Pregnancy in obese woman is considered as a high-risk pregnancy. Pre-pregnancy obesity and excessive gestational weight gain (GWG) are distinct risk factors with differing associated adverse outcomes, but they could also carry a cumulative negative impact on pregnancy course. Pre-pregnancy obesity is the anthropometric parameter most strongly correlated with perinatal complications. Maternal complications following obesity include antepartum, intrapartum and postpartum complications, such as pregnancy related hypertension, preeclampsia, gestational diabetes mellitus, preterm birth, venous thromboembolism, labor dystocia, labor induction, instrumental and cesarean delivery. Fetal complications related to maternal obesity might include increased prevalence of congenital anomalies, growth abnormalities, prematurity and stillbirth. Pre- pregnancy overweight and obesity is a potentially modifiable risk factor compromising pregnancy outcome. Among all complications that might arise during pregnancy and that could not be predicted and therefore prevented, pre- pregnancy overweight and obesity management control can significantly reduce potential pregnancy complications. Pre-conceptual counseling should provide in a timely manner awareness of this arising medical condition and provide risk reduction of complications following pre- pregnancy obesity and excessive GWG
obesity, pre-pregnancy obesity, excessive gestational weight gain, pregnancy risk factors, pregnancy complications
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2. Satpathy HK, Fleming A, Frey D, Barsoom M, Satpathy C, Khandalavala J. Maternal Obesity and Pregnancy. Postgrad Med. 2008 Sep; 120(3):E01-9.
3. Heerman WJ, Bian A, Shintani A, Barkin SL. Interaction between maternal prepregnancy body mass index and gestational weight gain shapes infant growth. Acad Pediatr. 2014 Sep-Oct; 14(5):463-70.
4. World Health Orgaization. Body mass index – BMI. Available from: https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi [Accessed 9th July 2020].
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6. Resnik R, Lockwood C, Moore T, Greene M, Copel J, Silver R, editors. Creasy and Resnik's Maternal- Fetal Medicine: Principles and Practice. 8th ed. Philadelphia: Elsevier; 2018.
7. Soma-Pillay P, Nelson-Piercy C, Mebazaa A, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016; 27(2): 89–94.
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11. Cavalcante MB, Sarno M, Peixoto AB, Araujo Júnior E, Barini R. Obesity and recurrent miscarriage: A systematic review and meta-analysis. J Obstet Gynaecol Res. 2019 Jan; 45(1):30-38.
12. Simnah, HN. Antepartum Care of the Obese Patient. Clin. Obstet. Gynecol. 2016; 59(1):148-157.
13. Ahlqvist HV, Persson M, Magnusson C, Berglind D. Elective and nonelective cesarean section and obesity among young adult male offspring: A Swedish population–based cohort study. PLoS Med. 2019; https://doi.org/10.1371/journal.pmed.1002996.
14. Taylor C, Dominguez J, Habib A. Obesity And Obstetric Anesthesia: Current Insights. Local Reg Anesth. 2019; 12: 111–124.
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16. Ramji N, Quinlan J, Murphy P, Crane J. The Impact of Maternal Obesity on Breastfeeding. J Obstet Gynaecol Can. 2016; 38(8): 703-711.
17. Howell K, Powell T. Effects of maternal obesity on placental function and fetal development. Reproduction. 2017; 153(3):97–108.
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