Obesity is becoming very common in Anguilla and is becoming a leading risk factor for pregnant women developing various complications. A pregnant woman can face many challenges during her pregnancy. Many studies have shown that being overweight or obese during pregnancy can have a major impact on the pregnant woman’s health and the health of the developing fetus.
What is considered overweight and obese?
Many health professionals use the body mass index (BMI) to help make the diagnosis of obesity. BMI is your body mass index which is a measure of your weight in relation to your height. A healthy BMI is in the range 18.5 to 24.9. A person with a BMI in the range 25 to 29.9 is considered overweight. A person with a BMI of 30 or above is considered to be obese. A BMI under 18.5 is considered underweight. To determine your body mass index, divide your weight in pounds by your height in inches squared and multiply by 703. Or divide your weight in kilograms by your height in meters squared.
High BMI and fertility
Having a high BMI can harm a woman’s fertility by inhibiting normal ovulation. Even in women who regularly ovulate, the higher the BMI the longer it appears to take to become pregnant. It should be emphasised that being overweight and obesity do not prevent a pregnancy from occurring.
High BMI and pregnancy
Most women who are overweight have a straightforward pregnancy and birth, and have healthy babies. However, being overweight or obese does increase the risk of complications to both the pregnant woman and her developing fetus/baby.
Having a high BMI during pregnancy increases the risk of various pregnancy complications including the following:
• The risk of miscarriage, stillbirth and recurrent miscarriage
• Gestational diabetes
• Pre eclampsia and eclampsia. This is a pregnancy complication characterised by high blood pressure and signs of damage to another organ system, most often the liver, brain and kidneys.
• Cardiac dysfunction
• Sleep apnoea
• The need for a C-section and the risk of C-section complications, such as wound infections
High BMI and effects on developing fetus and newborn
Having a high BMI during pregnancy has been linked to an increased risk of various health problems for a developing fetus and newborn. The problems include the following:
• Birth defects
• Being significantly larger than average (fetal macrosomia)
• Impaired growth
• Childhood asthma
• Childhood obesity
Decreasing the impact of a high BMI
There are several things that a woman who is overweight, or obese, can do to lessen the impact of a high BMI on a pregnancy. Prior to becoming pregnant individuals are encouraged to talk to their gynaecologist/obstetrician. He or she might refer you to other professionals such as a registered dietitian. Pregnant women who are overweight or obese are considered high risk pregnancies and should be under the care of an experienced obstetrician/gynaecologist. Regular prenatal visits are important to help to monitor the pregnant woman health and the health of the developing fetus. All pregnant women should eat a healthy diet, but this is of greater significance in individuals who are overweight or obese. Trying to lose weight by dieting during pregnancy is not recommended. However, by making healthy changes to your diet, you may not gain any weight during pregnancy and you may even lose a small amount. This is not harmful. If your BMI is 30 or above, you are advised to take a higher dose of folic acid (5mg per day).
Pregnant women with a high BMI are encouraged to be physically active. They should talk to their healthcare provider about safe ways to stay physically active during pregnancy. Physical activity will benefit both the pregnant woman and her baby. If the pregnant woman has not previously exercised routinely, she should begin with about 15 minutes of continuous exercise, three times per week, increasing gradually to 30-minute sessions every day. Some examples of healthy exercise include swimming, walking and pregnancy yoga.
Conclusion
Most women with a high BMI have a straightforward pregnancy and have healthy babies. However, being overweight or obese does increase the risk of complications for the pregnant woman and her baby. The higher your BMI, the greater the risks. Having regular prenatal visits and working with healthcare providers can help to decrease the risks and complications associated with having a high BMI during pregnancy.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field is ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
