Review article: Obesity in pregnancy
Article first published online: 10 AUG 2006
BJOG: An International Journal of Obstetrics & Gynaecology
Special Issue: Obesity
Volume 113, Issue 10, pages 1117–1125, October 2006
How to Cite
Yu, C., Teoh, T. and Robinson, S. (2006), Review article: Obesity in pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology, 113: 1117–1125. doi: 10.1111/j.1471-0528.2006.00991.x
- Issue published online: 10 AUG 2006
- Article first published online: 10 AUG 2006
- Accepted 28 April 2006. Published OnlineEarly 14 August 2006.
Overweight and obesity are common findings in women of reproductive age in the UK; as 32% of 35- to 64-year-old women are overweight and 21% obese. Obesity causes major changes in many features of maternal intermediary metabolism. Insulin resistance appears to be central to these changes and may also be involved in increased energy accumulation by the fetus. Maternal obesity is associated with many risks to the pregnancy, with increased risk of miscarriage (three-fold) and operative delivery (20.7 versus 33.8% in the obese and 47.4% in the morbidly obese group). Other risks to the mother include an increased risk of pre-eclampsia (3.9 versus 13.5% in the obese group) and thromboembolism (0.05 versus 0.12% in the obese group). There are risks to the fetus with increased perinatal mortality (1.4 per 1000 versus 5.7 per 1000 in the obese group) and macrosomia (>90th centile; 9 versus 17.5% in the obese group). Maternal obesity is associated with an increased risk of obesity in the long term. Obese woman should try to lose weight before pregnancy but probably not during pregnancy. There is no real evidence base for the management of maternal obesity but some practical suggestions are made.