01 Pregnancy and obesity
How might we improve the health in women and thus minimize the number of complications during pregnancy as well as limiting the transgenerational effect of obesity from one generation to the next?
Improving health between pregnancies in obese mothers
About one-third of women in Denmark enter pregnancy as overweight (Body Mass Index (BMI) ≥25 kg/m2) or obese (BMI ≥30 kg/m2). The global epidemic of obesity has had a major impact on women’s health and maternal obesity is recognized as one of the largest contributors to compromised health during pregnancy. There is a linear association between increasing BMI and a number of complications such as diabetes in pregnancy, preeclampsia, preterm birth, stillbirth and emergency cesareans. For the neonates there are increased risk of being born with a too high birth weight as well as increased risk of childhood obesity and obesity in later life.
Lifestyle interventions in obese pregnant women may be able to reduce weight gain during pregnancy, but they have shown limited success in improving pregnancy and neonatal outcomes. Since BMI before pregnancy is the single most important predictor of obesity-related complications, the maternal health in the first part of pregnancy or during time of conception may play a very important role. Observational studies have shown that weight loss between two pregnancies reduces the risk of high birthweight and other complications in a subsequent pregnancy. The time between first and second pregnancy is therefore considered an important target for lifestyle intervention in future trials.
Intervention between pregnancies with new mothers as target group should focus on a healthy diet, both during breastfeeding and later on, as well as improving physical activity. The intervention should be with overall information on healthy choices and with the opportunity to individualize a personal program in collaboration with the users as within her setting or frame and wishes according to weight loss, goals for physical activity etc. This solution might improve motivation, maintenance and compliance. The goal of such intervention is to improve health before the next pregnancy and thus to minimize the number of complications during pregnancy as well as limiting the transgenerational effect of obesity from one generation to the next.
- Name: Christina Anne Vinter, MD, PhD
Address: Department of Gynaecology and Obstetrics, Odense University Hospital, Odense
Phone +45 21782118