Pregnancy in overweight women

Preparing for pregnancy in an overweight woman

It is well known that weight loss is the most important goal when preparing for pregnancy. This increases the chances of becoming pregnant and reduces the risk of complications during pregnancy. Folic acid supplementation in a dose twice as high (800 ug/day) as for women of normal weight is also necessary. For women with insulin resistance, an OGTT test is also recommended in the period before conception.

Pregnancy in an overweight woman

The expectant mother should not gain more than 7 kg during pregnancy if she was previously overweight. It is important to pay attention to nutrition and regular meals. Physical activity is also important. A minimum of at least 150 minutes of physical activity per week. Ideally, this should be walking, running or stationary cycling and swimming. Antithrombotic prophylaxis with low-molecular-weight heparins is also very important for obese pregnant women. The decision on the use of these drugs is made by the attending physician. It is recommended for women with grade 2 obesity and for women with risk factors for thrombosis.

Pregnancy complications in an overweight woman

Pregnancy in an overweight woman is associated with possible complications. These can be divided into foetal complications, maternal complications and complications associated with the birth. These include: recurrent miscarriages, foetal anomalies, growth restriction (SGA, FGR) or macrosomia (LGA). The expectant mother has a higher risk of hyperglycaemia, high blood pressure, venous thrombosis or recurrent urinary tract infections. This in turn leads to further pregnancy complications, such as the risk of shoulder dystocia, pre-eclampsia or pyelonephritis.

Woman with obesity and childbirth

Being overweight in itself is not an indication for a caesarean section. However, it should be borne in mind that complications can occur in obese women not only during pregnancy but also during labour. Obese women are more likely to have a surgical delivery, perineal injuries, shoulder dystocia or perinatal haemorrhage. Wounds from perineal sutures or caesarean sections also heal less well and are more susceptible to infection.

Pregnancy in an overweight woman is a high-risk pregnancy and it is therefore recommended that the expectant mother is cared for by doctors in a health centre.