Excessive weight gain among expectant mothers is becoming such a serious problem. Experts say adding weight during pregnancy beyond the recommended amount can be dangerous to the mother and to the baby, reports Sade Oguntola.
Safe motherhood begins before a woman becomes pregnant and includes proper nutrition, healthy lifestyle, good body weight and good control of any chronic medical conditions like high blood pressure or diabetes. In pregnancy, safe motherhood continues with appropriate prenatal care, early identification and treatment of problems.
The health risks of being obese are certainly well known— diabetes, heart disease, stroke and hypertension, to name a few. But the dangers are even greater for pregnant women and particularly for their developing babies. Obesity during pregnancy is one of the most decisive factors in the development of heart, kidney and urinary tract defects in an unborn child.
Incidence of obesity in pregnancy is growing all over the world. It has become the fastest growing cause of women dying in pregnancy or childbirth in the United Kingdom. Even in Nigeria, a study that was carried out to determine the prevalence of obesity in early pregnancy and its subsequent outcome among Nigerian women found obesity in early pregnancy as a risk factor for adverse pregnancy outcome.
A total of 402 women were involved in the study which lasted three years with a breakdown of 201 obese cases and 201 non-obese controls. These were pregnant women who registered their pregnancy in the first trimester and delivered in the same hospital.
The study entitled “Maternal Obesity in Early Pregnancy and Subsequent Pregnancy Outcome in a Nigerian Population” was published in the African Journal of Reproductive Health (AJRH). It was carried out by Dr Michael Ezeanochie, Professor Adedapo Ande and Dr Biodun Olagbuji, all of the Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Edo State.
The study revealed that obesity was associated with pregnancy-induced hypertension and hospital admissions during pregnancy compared to non-obese women. Also, caesarean delivery was also significantly higher in pregnant women that were obese compared to their non-obese counterparts.
The research findings also showed that the number of stillbirths was higher among obese women with six cases (three per cent) while it was lower in non-obese women with two cases (one per cent), thus corroborating previous findings by researchers all over the world that being obese or overweight pose serious health problems during pregnancy.
Before this study, there was limited data on pregnancy outcome among African women with pre-pregnancy or early pregnancy obesity despite the rising prevalence of obesity worldwide.
Dr Ezeanochie, the study’s lead researcher, stated that out of 10 women who had caesarean section for severe pregnancy-induced hypertension for example, eight were obese.
He declared: “Pregnancy-induced hypertension and its consequences have been recognised as a leading cause of death of pregnant women worldwide. A reduction in the prevalence of obesity among pregnant women may reduce the occurrence of these complications with their attendant maternal morbidity and mortality, and ultimately help in promoting safe motherhood especially here in Nigeria.”
However, Dr. Ezeanochie stated that there was no significant difference between both the obese and non-obese pregnant women in the occurrence of gestational diabetes, preterm delivery before 34 weeks or in post-partum haemorrhage. Of the 402 women involved in the three-year study, no death was recorded.
According to him, in the Nigerian setting where many women are averse to delivery by caesarean section, a reduction in the prevalence of obesity among pregnant women may help in lowering the incidence of associated complications of pregnancy and consequent caesarean sections.
He declared: “It is our hope that the research findings will be useful in documenting the true nature of obesity in pregnancy among women, facilitate patient counselling and help medical care providers to anticipate situations that may lead to adverse pregnancy outcomes towards improving pregnancy outcomes and promoting safe motherhood in Nigeria.”
Obesity in pregnancy is usually defined as a Body Mass Index (BMI) of 30 kg/m2 or more at the first antenatal consultation. BMI is a simple index of weight-for-height and is calculated by dividing a person’s weight in kilogrammes by the square of their height in metres (kg/m2). A BMI that falls between 25.0 and 29.9 before pregnancy is taken as overweight.
Professor Dosu Ojendegbe, a consultant obstetrician and gynaecologist, University College Hospital (UCH), Ibadan, Oyo State corroborating that being overweight or obese in pregnancy was not healthy both for the woman and her unborn child, stated that excess weight gain in pregnancy was also better avoided because of its health implications.
He stated: “Generally, we expect people to gain between 10 and 20 kilogrammes of weight throughout pregnancy. So those who gain less than 10 kilogrammes are not gaining enough weight. And this could mean that the baby in the womb is not gaining enough weight or the body’s preparation is not adequate.
“For pregnant women who retain too much fluid or put on too much fat in pregnancy, such that they gain 12 kilogrammes or more, it may be difficult for them to lose a significant portion of the weight after childbirth. Now when that cumulates with each pregnancy, the woman could end up being severely overweight or obese.
“Being severely overweight or obese is not good, both for beauty and health purposes. The higher the body weight, the higher the attendant health problems the woman may experience. Overweight or obese women have an increased risk of diseases such as hypertension and diabetes. The excess weight may affect their joints. Of course, such women may be less attractive. “
Obesity is particularly dangerous for women of childbearing age because it creates a life cycle of serious problems that can be passed from generation to generation. Women need to prepare for their future children by eating “family friendly” or “baby friendly” portion sizes to reduce calorie intake and to limit second helpings of food. More physical exercise for women is required.