A woman’s weight before and during pregnancy can impact not only the health of the mother and baby around the time of childbirth, but also their long-term health.
For example, an American Journal of Clinical Nutrition study by researchers at the National Institutes of Health and the New York state Department of Health found that women who are obese before pregnancy are much more likely than normal weight women to have babies with congenital heart defects, some of which may be life threatening. Congenital heart defects are the most common type of birth defect, and they affect about eight in every 1,000 newborns.
On average, obesity increases a woman’s chance of having a baby with a heart defect by about 15 percent, and the risk increases with rising obesity. Moderately obese women are 11 percent more likely to have a child with a heart defect, and morbidly obese women are 33 percent more likely. In general, women who were overweight but not obese had no increased risk. In the United States, one in five women are obese at the beginning of pregnancy.
The results come from an analysis of 1.53 million births that took place in New York State (excluding New York City) over the course of 11 years. The researchers compared the records of mothers of 7,392 of children born with major heart defects to those of more than 56,000 mothers of infants born without birth defects.
Previous research has shown that obese women are also at higher risk for experiencing pregnancy-related problems such as high blood pressure, preeclampsia, and gestational diabetes. They also tend to have longer labors and give birth by Cesarean section more often than women of normal weight.
Obesity during pregnancy also puts a woman’s baby at increased risk for having a large body, which can lead to injuries during delivery, and certain birth defects such as neural tube defects. The baby is also at higher risk for developing type 2 diabetes.
Experts caution that while it is important to strive for a healthy weight before pregnancy, losing weight during pregnancy, even for obese women, can be dangerous to the developing fetus. In 2009, the Institute of Medicine released updated guidelines for weight gain during pregnancy. Most women need only about 300 extra calories per day during pregnancy.
“The amount of weight a woman should gain in pregnancy depends somewhat on her weight before pregnancy,” says Dr. Renee Goldberg, Medical Director of OB/GYN Community Practices at Beth Israel Deaconess Medical Center. “Women of normal weight should gain 25 to 35 pounds: three to five pounds in the first three months, another eight to 10 pounds in months four to six, and then a pound per week. Women who are overweight to begin with should gain much less.”
According to the U.S. Public Health Service, preconception care to ensure the best pregnancy and long-term outcomes includes getting at least 400 micrograms of folic acid for three months before pregnancy and for at least the first three months of pregnancy to prevent certain birth defects.
Also, before trying to get pregnant, women should receive immunizations or vaccines against diseases that could harm the developing fetus. The immunizations need to be administered several months before pregnancy to ensure healthy development.
In addition to maintaining a healthy weight and eating a healthy diet, other lifestyle behaviors that women should adopt if they think they may soon get pregnant include
- avoiding alcohol, illicit drugs, and smoking
- having regular physical and dental checkups
- controlling any existing health conditions
- avoiding exposure to toxic chemical, hazardous substances, certain medications, and animal feces
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted September 2012