Studies show that obese pregnant women are at increased risk for gestational diabetes, preeclampsia, eclampsia, cesarean section, macrosomia, instrumental delivery, fetal distress, antepartum stillbirth, and early neonatal death [1, 2]. Obese women have been found to have longer labor, are more likely to have inadequate contraction patterns during labor, and are more likely to receive labor induction and augmentation .
Healthy People 2010 goal 19-2 is to decrease the proportion of adults who are obese to 15 percent. Utah Vital records data indicate that in 2005, 14.5% of women with a live birth were obese before becoming pregnant, an increase of 30% since 1994. Utah is very close to exceeding the Healthy People goal among its pregnant women.
An analysis of Utah PRAMS data found that women who were obese prior to pregnancy were more likely to be older, of a race other than white, multiparous, and living at a lower poverty level. The analysis also found that obese Utah women were at increased risk of developing diabetes or hypertension, delivering a macrosomic infant, having labor induced, having their infant admitted to the newborn intensive care unit, and reporting postpartum depression . Vital Records data show that the highest rates of obesity in pregnant women are among the Pacific Islander and Native American women.
As weight loss is not recommended during pregnancy, weight issues should be addressed with women before they become pregnant. Body Mass Index should become a recorded measure on patient charts and reproductive aged women who have high weights should be counseled about achieving a healthy weight before pregnancy and their risks during pregnancy if they are at an unhealthy weight. Intermountain Health Care has published guidelines on the medical management of obesity; the document is available online at: https://kr.ihc.com/ext/Dcmnt?ncid=520199293
- Baeten, J.M., Bukusi, E.A., and Lambe, M.: Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health 91:436-40 (2001).
- Cedergren, M.I.: Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 103:219-24(2004).
- Vahratian, A., et al.: Maternal prepregnancy overweight and obesity and the pattern of labor progression in term nulliparous women. Obstet Gynecol 104:943-51(2004).
- Baksh, L., et al.: Maternal prepregnancy body mass index and pregnancy outcomes in Utah. PRAMS Perspectives, 2005.
- Vital Records data retrieved on 1/12/2007 from Utah Department of Health, Center for Health Data, Indicator Based Information System for Public Health website: http://ibis.health.utah.gov.