In the United States, nearly one-third of childbearing-age women are significantly overweight. Significantly overweight is defined by a body mass index (BMI) – calculated from a person’s weight and height – of 30 or greater. For example, an adult who is 5'9" and weighs more than 203 pounds is considered significantly overweight.
Dr. Brian Brocato, assistant professor of obstetrics and gynecology at the University of South Alabama College of Medicine and an obstetrician and gynecologist with USA Physicians Group, said being significantly overweight can cause several complications during pregnancy, for both the mother and the baby.
“Being significantly overweight places pregnant women at risk for complications such as hypertension (high blood pressure), venous thrombosis, diabetes (high blood sugar) and cesarean delivery.” he said. “It has also been linked to premature delivery, congenital heart disease and stillbirth.”
According to Dr. Brocato, there are some things women can do before and during pregnancy to limit the impact being overweight has on their pregnancy.
“It is important for women who are significantly overweight to maintain a balanced diet and regular exercise schedule, both before and during pregnancy,” Dr. Brocato said. Thirty minutes of moderate exercise daily – such as swimming, walking and yoga – is recommended. Dietary needs in significantly overweight women are best addressed in conjunction with a dietician or nutrition expert, although a 2,500 calorie diet is typically recommended.
Ideally, Dr. Brocato said women who are significantly overweight and desire pregnancy would meet with their doctor prior to becoming pregnant. “Your nutritional status can be assessed and we can assist in weight loss strategies,” he said. “By reaching a healthy weight, you reduce your risk of the complications associated with being overweight in pregnancy.” Some women may even be candidates for bariatric (weight loss) surgery, which can lower the risk of complications.
For women who are already pregnant and are significantly overweight, Dr. Brocato said it is important for them to maintain their weight gain during their pregnancy. If you’re significantly overweight and carrying one baby, the recommended weight gain is 11 to 20 pounds. If you’re significantly overweight and carrying twins or multiples, the recommended weight gain is 25 to 42 pounds. Patients who are significantly overweight should be cautioned against trying to lose weight during pregnancy as this may not be safe.
If you’re significantly overweight, your health care provider will closely monitor your pregnancy. Because of the increase in risk of stillbirth, some doctors may elect to perform tests for fetal health – such as a non-stress test (NST) or biophysical profile (BPP) during the third trimester. Dr. Brocato said it is also recommended to have an anesthesia consultation near the estimated due date or in early labor. If cesarean delivery is necessary, dosing adjustments for preoperative antibiotics are given to women who are significantly overweight.
Dr. Brocato encourages these women to breastfeed and seek weight loss counseling after pregnancy. “Not only does breastfeeding benefit the health of the mom and baby, but it also is associated with less postpartum weight retention,” he said.
Dr. Brocato sees patients at the Strada Patient Care Center located at 1601 Center Street. To make an appointment, call (251) 415-1496.
© 2018 USA Health System