Obesity and pregnancy share a turbulent relationship. Being obese could lead to serious complications from conception up to delivery.
“With the rising prevalence of obesity and infertility, fertility interventions are needed to prevent and treat the conditions. Lifestyle changes are a vital component of such strategies,” explains Dr. Poornima Kinila Consultant – Obstetrics & Gynaecology and Infertility, Aster RV Hospital.
According to Dr Chandrika Anand, Senior Consultant, Fortis Hospital, Nagarbhavi Bangalore, “Obesity in women or men comes with issues like high cholesterol, high blood pressure, diabetes, cardiovascular condition, etc, all resulting in metabolic syndrome which can trigger pregnancy related complications.”
Some of the common complications of obesity and pregnancy are:
1. PCOS
Women with PCOS (Polycystic ovary syndrome) have hormonal imbalance and raised levels of testosterone. They also tend to produce a lot of insulin and may be insulin resistant which can lead to weight gain. “PCOS and obesity both make ovulation difficult leading to infertility,” explains Dr Anand. Experts explain that women with PCOS are prone to developing small sacs of fluid on the ovaries which interfere with release of eggs from ovaries and cause problems in conceiving.
2. Increased chances of miscarriage
“Overweight women have an increased chance of miscarriage due to weight related comorbidities like diabetes and blood pressure which can also cause cardiovascular issues,” says Dr Kinila. She explains there are also chances of stillbirth in some women.
3. Higher risk of child having birth defects
Research indicates that women who are obese have double the chance of delivering a baby with congenital heart defects (heart conditions present at birth) or neural tube defects (birth defects affecting the spine or brain). Dr Kinila explains sometimes there can also be malformation of limbs or genitals.
4. Premature labor or preterm baby
Maternal obesity increases the risk of gestational diabetes (diabetes that develops during pregnancy) and hypertensive disorders (high BP) of pregnancy. Sometimes infection in the uterus and premature breakage of the water bag could also result in preterm delivery which can lead to other complications. “If there are complications post-delivery, the baby may require NICU admissions,” adds Dr Anand.
5. Cesarean delivery
Sometimes obese women face issues like dystocia (difficult or obstructed labor.) It could be because of slow dilation of the cervix or something like shoulder dystocia in which the shoulder of the baby gets stuck during normal delivery. Overweight women have an increased chance of being given inducted labor. “Sometimes induced labor fails and the doctor must resort to a C section or instrumental delivery done using forceps or a ventouse suction cup,” explains Dr Anand.
6. Gestational diabetes risk high
Many women are prone to gestational diabetes during pregnancy. That’s because many hormonal changes take place in the body during pregnancy including weight gain. Sometimes this weight gain leads to insulin resistance and hampers insulin’s ability to convert glucose into energy leading to gestational diabetes. “In some cases, women may deliver a big baby due to uncontrolled sugar levels during pregnancy,” explains Dr Kinila.
7. High BP related issues
In obese women during pregnancy, if they have high blood pressure (as a result of obesity), it can restrict the smooth flow of required amount of oxygen and nutrients that the baby receives through the placenta. This leads to health and growth complications. Another issue some mothers may have to grapple with, is the risk of clot formation called as venous thrombosis or increased incidence of preeclampsia (high blood pressure and liver or kidney damage that occurs in women after the 20th week of pregnancy).
8. Health complications risk in babies
Obesity is usually associated with chronic inflammation which may also impact the way the babies’ immune system develops and functions. This makes them develop allergic conditions like asthma or wheezing.
9. Childhood obesity risk
According Dr Rajath Athreya Senior Consultant and HOD Pediatrics and Neonatology Sakra World Hospital Bengaluru there also seems to be an emerging link between maternal obesity, gestational diabetes and fetal programming (tissues and organs are created during embryonic and fetal development) leading to childhood obesity and poor metabolic health. “All these factors are of great concern because ill effects of obesity seem to be transgenerational,” explains Dr Athreya.
Reducing weight helps
Many studies have provided encouraging data on the substantial impact of lifestyle changes in women with obesity and infertility. The good news is that even five to ten percent of weight loss goes a long way in improving the ovulation rate and pregnancy rate in overweight women. “So, if a woman comes to an infertility clinic when she is 100 kgs and loses anywhere between at least 5 to 10 kgs, it can reverse so many metabolic complications. This results in conceiving a child and a safer pregnancy,” explains Dr Anand.
Takeaway
Excess body weight and obesity could pose multiple issues during pregnancy right from the initial stages of ovulation until the delivery. Most obese women are also at high risk of developing gestational diabetes and also type 2 diabetes later. Experts however point out that all these complications could be effectively addressed by adopting a healthy lifestyle and diet to keep a close watch on body weight.
