Obesity and your baby
Jordan H. Perlow, MD, is a maternal fetal medicine specialist and director of Maternal-Fetal Medicine at Banner – University Medical Center Phoenix. His office can be reached at (602) 839-2647.
Question: I have struggled with my weight for years and was recently told that I am clinically obese. Can I still have a baby?
Answer: Yours is an important question that, unfortunately, most obese women don’t consider when starting a family. The reality is that obesity among pregnant women is directly tied to an array of serious health risks for both mother and baby.
Any woman who is overweight or obese should achieve a normal body mass index (BMI), a calculation of weight and height, prior to conception. Whether through nutrition and exercise, medical intervention or bariatric surgery, a normal BMI promotes better pregnancy outcomes. A BMI between 18.5 and 25 is considered normal; 25 to 30 overweight; and 30 or higher obese.
Obesity is an independent risk factor for virtually all pregnancy complications that puts obese women at a much higher risk for birth defects, premature birth, large babies and the need for cesarean delivery (C-section). Spina bifida, cleft lip and palate, abdominal wall defects and cardiac defects are just some of the many fetal development issues linked to obesity. Detecting these defects is complicated by the fact that ultrasounds must penetrate fatty tissue to provide a clear view of the fetus.
Women who are obese are three to four times more likely to develop preeclampsia, a pregnancy complication characterized by high blood pressure and protein in the urine. Unfortunately, preeclampsia can only be cured through delivery, which generally results in premature birth.
Obese women also run the risk of carrying large babies, typically between nine and 10 pounds. In addition to concerns about in utero programming and the increased potential for childhood obesity, large babies present delivery challenges since they may not fit through the pelvis. C-section rates are three to four times higher among obese women, which present an increased risk of blood loss, pneumonia, infection and more. Furthermore, the extra preparation required when performing C-sections on obese women hinders physicians from delivering babies easily and expeditiously.
Two-thirds of American women are overweight or obese, and weight-related pregnancy complications continue to rise. Speak with your physician about your desire to start a family and work to reduce your risk prior to conception.