The new studies emphasize the need to reach a healthy weight before and during pregnancy. Women who suffer from obesity when they become pregnant can face significant risks to their health and their babies’ health and future well-being.
Obesity among European women
In several European countries, it is estimated that more than half of the adult population is overweight, and between 20% and 30% suffer from obesity [body mass index (BMI) >30 kg/m2]1. The prevalence of obesity in pregnant women ranges from 1.8% to 25.3%2. Obesity during pregnancy requires special attention due to its effects on mother and child. Maternal obesity is associated with increased risks and complications during pregnancy and leads to higher maternal and infant mortality rates than non-obese mothers.
Optimal weight gain during pregnancy
The energy needs of the diet increase during pregnancy, but only during the last trimester and by about 200 kcal daily. Therefore, there is no need to “eat for two.” This additional demand increases to about 675 kcal per day during the lactation period to cover milk production. Studies show that the healthiest pregnancy is associated with a BMI of 23 kg/m2 3. However, weight gain during a healthy pregnancy varies and depends on pre-pregnancy body weight and the presence of edema.
Recommendations on optimal weight gain during pregnancy are currently under debate. According to the World Health Organization, an optimal birth weight of 3.1 to 3.6 kg was associated with an increase in the mother’s weight of between 10 and 14 kg.4. U.S. Institute of Medicine guidelines for weight gain during pregnancy suggests that underweight pregnant women should gain between 12.5 and 18 kg, those of average weight between 11.5 and 16 kg, those who are overweight between 7 and 11.5 kg, and those with obesity. Between 5 and 9 kg5. Rapid weight loss and crash diets during pregnancy can be hazardous and produce ketoacidosis, which can lead to the baby’s death or a deterioration of their cognitive faculties in the future. Mothers who restrict food consumption excessively during pregnancy could put their children at risk of obesity unintentionally6.
Consequences of obesity during pregnancy
Being overweight or obese before and during pregnancy increases the risk of complications during pregnancy. Women with obesity have an increased risk of miscarriage and premature birth or death of the baby7. In addition, complications in childbirth are a common consequence of maternal obesity, which increases the chances of delivery by emergency cesarean section. Other complications in childbirth for women with obesity include hypertension and preeclampsia, the birth of a large baby, and gestational diabetes.
Women affected by obesity also face difficulties in starting and maintaining breastfeeding.8. In addition, the babies of these obese women are more likely to develop congenital disabilities (e.g., spina bifida or heart defects).9. Excessive weight gain during pregnancy can also lead to permanent obesity. This highlights that, for women suffering from obesity, pregnancy is an opportunity to switch to a healthier diet and an improved lifestyle, and future healthier pregnancies. Proper diet and exercise after childbirth could help women lose postnatal overweight10.
Maternal obesity and subsequent child health
The mother’s specific metabolic conditions could negatively affect the child’s health. The child of a mother who is obese could undergo inadequate development due to exposure to a healthy environment below the optimal level in the womb. In addition, new studies have shown that what a woman eats when she is pregnant can affect the child’s risk of obesity, regardless of her constitution and the baby’s weight at birth.11. Two EU-funded projects, EDEN (Studying Prenatal and Postnatal Determinants in Child Development and Health) and EARNEST (Early Nutrition Programming Project), study these issues.
Conclusions
Pregnancy is a vulnerable period in nutrition and health for mother and baby. It is recommended to reach the optimal weight before pregnancy and increase the appropriate weight during pregnancy to ensure the safe delivery of a healthy baby and the child’s future health.
More information
EARNEST Website: http://www.metabolic-programming.org/ EDEN
Publications: http://www.ifr69.idf.inserm.fr/page.asp?page=2248