Healthy pregnant with overweight

How does my weight affect my unborn child and me?

Most pregnant overweight women experience both pregnancy and childbirth without health problems.

Even so, if you are severely overweight and have an increased body mass index (BMI), you may also be at higher risk of certain complications during pregnancy. Presumably you will not experience any of these complications and yet it is good to be aware that they might occur and how you can protect yourself from them.

The medicine knows no exact reasons why the weight of the expectant mother has an influence on the pregnancy. Many other aspects also play a role - your age, your family history, your lifestyle and your ethnic origin (NCCWCH 2008). However, one thing is clear: the higher your BMI, the greater the likelihood of complications during pregnancy (RCOG 2011).

Here are some of the common complications that can occur in pregnancy and are associated with overweight or obesity:

  • Gestational diabetes (Gaillard et al 2013, Bautista-Castaño et al 2013)
  • Hypertension (Pregnancy hypertension) (Gaillard et al 2013, Bautista-Castaño et al 2013)
  • Pre-eclampsia, which occurs when the uterus is no longer adequately treated (Gaillard et al 2013, Bautista-Castaño et al 2013)
  • premature labor pains (Smith et al 2007, Cnattingius et al 2013)

But being overweight can also be the reason for a transmission (Denison et al 2008), which may then require an introduction again.

With a BMI of 30 or above,

  • Obstetrics (forceps or suction cup) may be used (Morken et al 2013)
  • you need a caesarean section (Gaillard et al 2013, Bautista-Castaño et al. 2013, Scott-Pillai et al. 2013)
  • increased or severe postpartum hemorrhage (postpartum hemorrhage or PPH) may occur (Scott-Pillai et al 2013, CMACE, 2010)
  • after a cesarean section to a wound infection (CMACE RCOG, 2010)
  • a deep vein thrombosis or pulmonary embolism occurs (Sultan et al 2013, Jacobsen at al 2008)
  • a longer hospital stay due to complications is necessary (Crane et al 2013, CMACE, 2010)

Being overweight or obese also more likely to have a very large baby (macrosomy) (Gaillard et al 2013, Bautista-Castaño et al 2013, Scott-Pillai et al 2013).

It's also possible that you may end up having a very small baby because of the heavy weight and obesity, as the pregnancy can not be monitored as well. Most women with a BMI of 40 and over are advised to take additional ultrasound scans to better control the baby's growth.

Despite a low probability, obesity can increase the risk of damage to the baby. These damages can affect the baby's brain, its spinal cord (neural tube defects), the heart or the abdominal wall. However, these are very rare diseases (Stothard et al 2009).

You can protect your baby from neural tube problems if you take 0, 4 mg of folic acid every day during the first trimester of your pregnancy (or better yet). It is also recommended that you take 5 mg daily under certain conditions. Ask your gynecologist or gynecologist for the exact application and dose.

What can I contribute to a healthy pregnancy?

It's actually pretty easy to get through the pregnancy of healthy and to help your baby in its development optimally. Eat a healthy diet, exercise regularly, and stick to your weight requirements.

There are no studies that support dieting during pregnancy (RCOG 2011). Rather, even the opposite, sometimes a diet can harm the unborn child. If you suffer from nausea and vomiting in the first weeks of pregnancy, you will not be much interested in a healthy diet. Nevertheless, make sure that you drink enough liquid and several small but nutritious meals a day.

A balanced diet is the best for you and your baby. Choose nutrient-rich foods that will not immediately convert to sugar during digestion. Eat enough vegetables and fruits. Do you prefer whole wheat and wholegrain flours, such as B. wholemeal bread or wholegrain spaghetti. Avoid fat and sweet as much as possible. High fiber and starchy foods contain all the nutrients you and your baby need and they fill you up.

In addition to a healthy diet, important supplements are also needed. If you have a BMI over 30, some doctors recommend a higher folic acid dose than the usual 400 micrograms. Since this dose (5 milligrams) is many times higher than the usual intake, you need a doctor's prescription. Start taking it no later than 4 weeks before a planned pregnancy and keep this dose for the first 12 weeks of your pregnancy, during which time your baby's nervous system will develop (CMACE / RCOG 2010).

You may also be advised to take a higher dose of vitamin D during your pregnancy and later during breastfeeding.Vitamin D supports the bones and teeth of your child. Especially if your BMI is over 30, as it is often deficient in this vitamin (CMACE / RCOG 2010).

Regular exercise supports your body during pregnancy and prepares it optimally for childbirth (RCOG 2006, NCCWCH 2008). Sport is the most effective way to control body weight, especially when combined with a healthy diet. This can also reduce the risk of having a very large child (Petrella et al 2013, NICE 2010).

However, if you have not exercised until the beginning of your pregnancy, you should take it easy and slow. Preferably under the control of a trainer who is specially trained for pregnant women or your doctor.

Choose moderate sports such as Nordic walking or swimming (NICE 2010). Start with short workouts that keep you going. Do not forget to drink enough (as still as possible).

Discuss your personal life circumstances with your doctor. Maybe you are suffering from diabetes or hypertension. Maybe big babies have been born in your family. Equipped with this knowledge, some risks can be eliminated or minimized, which in turn increases your chances of a healthy baby.

Sources

Bautista-Castaño I, Henriquez-Sanchez P, Alemán-Perez N, et al, 2013. Maternal obesity in early pregnancy and risk of adverse outcomes. PLoS One . Nov 20: 8 (11)

Carmichael SL, Shaw GM, Schaffer DM, et al. 2003. Dieting behaviors and risk of neural tube defects. At the J Epidemiol. 158 (12): 1127-1131.

Center for Maternal and Child Inquiries. 2010. Maternal obesity in the UK: Findings from a national project . London: CMACE

Center for Maternal and Child Inquiries / Royal College of Obstetricians and Gynecologists. 2010. Joint Guideline Management of Women with Obesity in Pregnancy . London: CMACE / RCOG.

Cnattingius S, Villamor E, Johansson S, et al. 2013. Maternal obesity and risk of preterm delivery. JAMA 309 (22): 2362-70

Crane JM, Murpy P, Burrage L, Hutchens D, 2013. Maternal and perinatal outcomes of extreme obesity in pregnancy. J Obstet Gynaecol Can. 35 (7): 505-11

Denison F, Price J, Graham C, et al. 2008. Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labor at term. BJOG , 115: 720-725.

Gaillard R, Durmus B, Hofman A, Mackenbach JP, Steegers EA, Jaddoe VW, 2013. Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy. Obesity (Silver Spring) 21 (4): 1046-55

Jacobsen A., Skjeldestad F., Sandset P. (2008) Ante- and postnatal risk factors of venous thrombosis: a hospital-based case control study Journal of Thrombosis and Haemostasis 6 (6): 905-912

Morken NH, Klungsøyr K, Magnus P, Skjærven R, 2013.Pre-pregnant body mass index, gestational weight gain and the risk of operative delivery. Acta Obstet Gynecol Scand. 92 (7): 809-15

NCCWCH. 2008. Antenatal care: routine care for the healthy pregnant woman. National Collaborating Center for Women's and Children's Health, Clinical Guideline. London: RCOG Press.

NICE. 2010. Weight Management before, During and After Pregnancy: Dietary Interventions and Physical Activity Interventions for Weight Management Before, During and After Pregnancy . National Institute for Health and Care Excellence. London: NICE

Nohr E, Vaeth M, Bech B et al. 2007. Maternal Obesity and Neonatal Mortality According to Subtypes of Preterm Birth. Obstet Gynecol . 110: 1083-1090

Petrella E, Malavolti M, Bertarini V, et al. 2013. Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program. J Matern Fetal Neonatal Med. Nov 25

RCOG. 2011. Why your weight matters during pregnancy and after birth. Royal College of Obstetricians and Gynecologists.

RCOG. 2006. Exercise in pregnancy . Royal College of Obstetricians and Gynecologists (RCOG) Statement no. 4.

Scott-Pillai R, Spence D, Cardwell CR et al. 2013. The impact of body mass index on maternal and neonatal outcomes: a retrospective study in a UK obstetric population, 2004-2011. BJOG 120 (8): 932-9

Smith G, Shah I, Pell J, et al. 2007 Maternal Obesity in Early Pregnancy and Risk of Spontaneous and Elective Preterm Deliveries: A Retrospective Cohort Study. Obstet & Gynecol Survey 62 (5): 299-300

Stothard KJ, Tennant PW, Bell R, et al. 2009. Maternal overweight and obesity and the risk of congenital anomalies: a systemic review and meta-analysis. JAMA 301 (6): 636-50

Sultan AA, Tata LJ, West J, Fiaschi L, et al. 2013. Risk factors for first venous thromboembolism around pregnancy: a population-based cohort study from the United Kingdom. Blood . 121 (19): 3953-61

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