OBESITY IN PREGNANCY

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

Obesity during pregnancy is defined as a body mass index (BMI) of 30 or higher. It is a significant health concern, as it increases the risk of complications for both you and your baby.

Some weight gain during pregnancy is not only normal – it’s necessary. Healthy weight gain is important for the health of both you and your child. However, the amount of weight you put on is influenced by how much you weighed before pregnancy, amongst other factors. This means it is still necessary to monitor your weight gain, as being overweight increases your risk of health problems.

If you were a healthy weight before you became pregnant, you can expect to gain half a kilogram per week in your second and third trimesters
If you are pregnant with more than one baby, you may need to gain more
However, if you were already overweight before you became pregnant, you may need to gain less

With proper management, most obese pregnant women can have a healthy pregnancy and a healthy baby. It is important that you consult your healthcare provider regularly to both monitor your weight gain and get advice on how best to manage your weight throughout your pregnancy. They will also monitor you for any potential complications you or your baby may encounter.

MATERNAL OBESITY IN SOUTH AFRICA

More than half of adult South African women are overweight, and almost 30% are obese. It is therefore no surprise that obesity during pregnancy is a significant public health concern in South Africa.

The 2018 South African Demographic and Health Survey estimated obesity among pregnant women to be:

6% for women aged 15-19 years
9% for women aged 20-29 years
3% for women aged 30-39 years
7% for women aged 40-49 years

RISKS FOR THE MOTHER

High blood pressure, preeclampsia and blood clotting problems
Gestational diabetes
Increased risk of caesarian delivery (C-section)

Too much body fat may block the passage of your baby through the pelvis, making it more likely you will require a C-section. Unfortunately, obesity also makes it more likely that you’ll have complications from a C-section, like an infection or losing too much blood.
Other:
Increased risk of miscarriage or stillbirth

Increased risk of sleep apnoea

Higher likelihood of infections during pregnancy, like urinary tract infections

Difficulty losing your pregnancy weight after giving birth

RISKS FOR THE BABY

Premature birth
Being very large at birth

If your baby weighs 4kg or more at birth, they are considered Large for Gestational Age (LGA). Babies this large can cause complications during labour and birth, for both mother and child. LGA increases your chances of needing a C-section, and your baby has a higher risk of low blood sugar (hypoglycemia) after birth, especially if you have gestational diabetes. These babies may also experience breathing difficulties and require additional monitoring after delivery.
Birth defects

A birth defect is a health condition that a baby has at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, in how the body develops, or in how the body works. If you are obese, it may be hard for your healthcare provider to diagnose birth defects during pregnancy, even with tests like ultrasound.
If you have gestational diabetes
Increased risk of childhood obesity

MANAGING MATERNAL OBESITY

Women who are planning to become pregnant should consult their healthcare provider to discuss their weight and any potential risks. It is preferable to get to a healthy weight before you get pregnant.

With proper management, however, if you are overweight you can still have a healthy pregnancy and baby. Not all obese women experience complications during pregnancy. Consult your healthcare provider for a personal management plan, so that you and your child can be safely monitored.

Get early and regular prenatal care

Regular prenatal checkups are essential to monitor the health of both you and your baby. Ensure you go to every prenatal care checkup, even if you’re feeling fine. Your healthcare provider will conduct essential prenatal tests, like a glucose screening test for diabetes and ultrasound to get a picture of your baby in the womb.
Don't diet

Losing weight during pregnancy is not recommended. Some diets can reduce the nutrients your baby needs to grow and develop. Don’t try to stay at the same weight or lose weight during pregnancy. Talk to your healthcare provider about how much weight you should gain during your pregnancy.
Eat healthy foods

Your healthcare provider can help you make a healthy eating plan based on your age, weight, height and physical activity. Being pregnant is hard on your body, and you need to not only get enough nutrients in for yourself but also to make sure that your baby grows up strong and healthy.

You should eat plenty of whole grains, leafy vegetables, lean protein and dairy.

You should avoid caffeine, any raw foods, tobacco products and alcohol.
Do something active every day

Regular exercise is recommended for a healthy pregnancy. It improves posture, and can reduce backaches, swelling and constipation. However, if you didn’t do any sport before becoming pregnant, now is not the time to start! Stick to low-impact exercises like walking, swimming, biking and prenatal yoga.
Medications

OBESITY IN PREGNANCY

OBESITY IN PREGNANCY

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

MATERNAL OBESITY IN SOUTH AFRICA

RISKS ASSOCIATED WITH MATERNAL OBESITY

RISKS FOR THE MOTHER

RISKS FOR THE BABY

MANAGING MATERNAL OBESITY

FURTHER READING