Pregnant women who are overweight or obese are more likely to suffer from complications during pregnancy and their babies face increased risks, according to research published in the current issue of the Medical Journal of Australia.
Dr Leonie Callaway and colleagues, at the Mater Hospital and Princess Alexandra Hospital in Brisbane, found that over 30 per cent of a sample of pregnant women were overweight or obese. The sample comprised 14 230 women who had a single child delivered at the Mater Mothers’ Hospital between January 1998 and December 2002.
The authors found that increasing Body Mass Index (BMI) was associated with longer hospital stays and with increased rates of gestational diabetes, type 2 diabetes, chronic hypertension, and hypertensive disorders of pregnancy.
Increasing maternal BMI was also associated with increased risk to babies, including higher rates of admission to the intensive care nursery, birth defects, respiratory distress syndrome, hypoglycaemia and prematurity.
The authors say the increased health risks for mother and baby have important implications for the cost of obstetric care. Caring for an increasingly obese obstetric population also presents practical problems, including difficulty with lifting patients, gaining venous access and finding appropriate beds and operating tables.
The authors recommend that data on maternal BMI be collected routinely to provide valuable information for resource planning for obstetric and neonatal care.
In an editorial in the same issue of the Journal, Dr Alison Nankervis and colleagues from the Royal Melbourne Hospital and the Royal Women’s Hospital in Melbourne, say the ability to conceive spontaneously is reduced by obesity and that even a slightly elevated BMI at the age of 18 increases the risk of infertility.
“The increased pregnancy-related risks of obesity include increased rates of miscarriage, gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, thromboembolism, haemorrhage, caesarean section, sleep apnoea, wound infection and anaesthetic complications,” Dr Nankervis said.
Moreover, babies of overweight or obese women are more likely to have congenital abnormalities such as neural tube and cardiac defects. Birth-related injuries and fetal death are also higher in this group, and babies are more likely to be larger than normal, placing them at risk of birth trauma and possible lifelong obesity.
But research has shown that a relatively small weight loss (6-10 kg) can lead to resumed ovulation, with increased pregnancy rates and a decline in the rates of miscarriage.
“Given the potential for adverse health outcomes for both mother and baby, and the potential lifelong effects on neonatal macrosomia (big babies), there is a pressing need for action well before conception,” Dr Nankervis said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT Dr Leonie CALLAWAY 0408 183 441
Dr Alison NANKERVIS 0400 269 592 / 03 9380 6886
Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471