| Keywords [eng] |
Obesity, pregnancy outcomes, gestational diabetes, hypertensive disorders in pregnancy, preterm birth, stillbirth, macrosomia, cesarean section, preeclampsia |
| Abstract [eng] |
Obesity is considered one of the main risk factors for fertile and pregnant women. According to world health organization the prevalence of obesity has doubled in the last 30 years. The following narrative review covers adverse effects of obesity on mother and offspring; hence an adequate management of obesity will be recommended. Obese women are at higher risk for multiple adverse pregnancy outcomes including thromboembolism, gestational diabetes, miscarriage, stillbirth, postpartum depression, postpartum hemorrhage, and difficulties with breastfeeding. But obesity also effects the unborn child. They are more likely to be either large or small for gestational age, experience fetal distress and are more likely to be admitted to neonatal intensive care units. Those complications and comorbidities are closely related to pathophysiological changes during pregnancy. In obesity the first anabolic state is missing, leading to insulin resistance early in pregnancy causing hyperinsulinemia, impaired glucose, and lipid metabolism causing macrosomia. Impaired placental invasion and function due to endothelial impairment plays a major role in small gestational age babies. Hence, close monitoring and clear guidelines are needed. There are several recommendations for the management of obese women before, during and after delivery and pregnancy. Those recommendations include antenatal weight loss, management of comorbidities and the supplementation of high dose folic acid and vitamin D daily. Weight gain should be minimized during pregnancy and close monitoring is recommended to ensure early detection. Vaginal delivery should be emphasized. Breastfeeding and postpartum weight loss must be encouraged. |
