Challenge 2: Obesity in pregnancy application
Maternal obesity has become highly prevalent worldwide and is associated with adverse outcomes for mother and infants. As one of the most common risk factors, maternal obesity remains a significant obstetric challenge and more than 12% of Danish pregnant women are obese (Body Mass Index >30 kg/m2). Pregnancy offers the opportunity to manage or prevent obesity, but there is a lack of intervention studies showing an effect on these problems.
Several studies have shown that maternal obesity is related to a number of adverse outcomes including abortion, gestational diabetes mellitus (GDM), preeclampsia, stillbirth, macrosomia and cesarean section. Maternal obesity leads to obesity in infancy and among young adults and the long-term consequences can be seen in observational studies. Both pre-pregnancy BMI and weight gain during pregnancy are strong predictors for high birth weight and obesity in infancy and adulthood.
The increased risk of GDM has both short and long-term consequences for mother and offspring and increases the development of diabetes in future generation. The management of obesity in pregnancy includes the recommendation of appropriate GWG. In 2009, the American Institute of Medicine (IOM) recommended a GWG of 5-9kg in obese women (BMI30 kg/m2). Some observational studies have suggested that a GWG of <5kg may reduce the number of complications without increasing the risk of adverse outcomes.
Christina Vinter, MD, PhD
Department of Gynaecology and obstetrics, Odense University Hospital