19 January 2015

Pregnant and overweight – the facts

If you’re overweight and pregnant, now’s the time to stop thinking that eating for two is okay.


Being pregnant and overweight or obese is associated with many health complications – not only for you, but also for your unborn baby. And many women and their unborn children are at risk: after all, the prevalence of obesity among women of childbearing age has doubled over the past two decades.

Unfortunately, a great percentage of women don’t do what’s advised by medical practitioners and lose excess weight before falling pregnant.

Read: Eating for two - don't overdo it!

In the UK, for example, an estimated 16 - 18% of pregnant women are obese from the start of their pregnancy.

But what are the implications really? Do a few extra kilos really make such a difference?

Possible complications

Obesity and overweight in pregnancy really do go hand-in-hand with a string of health complications, which includes a risk for:

- Venous thromboembolism (when a blood clot breaks loose in a deep vein, from where it may travel to the lungs)
- Sepsis (a potentially life-threatening complication of infection)
- Gestational (pregnancy) diabetes
- Hypertensive disorders (high blood pressure)
- Heart disease
- Miscarriage, stillbirth, premature birth, foetal abnormalities and neonatal death.

Diabetes UK and other researchers have furthermore found that pregnant obese women have higher rates of induced labour, caesarean sections, forceps delivery and post-partum haemorrhage (severe loss of blood).

In addition, if a woman remains obese after giving birth, her risk of developing various conditions such as type 2 diabetes, digestive problems, urinary incontinence, pelvic-floor disorders, endometrial polyps and fibroids increases.

Long-term impact on baby

Pregnancy weight gain may also hold other serious, long-term consequences for the child. For example, research from Boston Children's Hospital in Massachusetts found that women who gain excessive weight during pregnancy are at higher risk of having overweight or obese children.

The study, published in the journal PLOS Medicine, was aimed at establishing whether childhood obesity is due to conditions during pregnancy, and involved 42,133 women who had more than one single pregnancy and 91,045 children.

Read: Diabetes risk in pregnancy tied to weight change

Study author Dr David Ludwig commented that pregnancy weight gain could “programme” the offspring to an increased long-term risk for obesity, independent of genes and environment. “In other words, obesity could spread across generations unless something is done to break this vicious cycle.”

What actually causes obesity in the offspring of obese pregnant women may be explained by Dr Claire de La Serre of the University of Georgia, Athens.

In her research findings presented at the Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB) in July 2014, Dr de La Serre noted that maternal obesity leads to “marked changes in the offspring's gastrointestinal micro-flora composition and gastrointestinal function”.

She explained that gastrointestinal micro-flora consists of multiple species of microorganisms that live in the digestive tract and which assists in digestion. Where there’s an imbalance in an individual's micro-flora, it appears to contribute to the development and persistence of obesity.

Prevention better than cure

Medical experts like obstetrician Dr Deirdre Lyell, Associate Professor of Obstetrics and Gynaecology at Lucile Packard Children's Hospital in California, stress the importance of losing weight before becoming pregnant by following a healthy diet and exercise programme.

She advises that women who are obese should also consider meeting their obstetrician to discuss and understand their specific health risks.

Read: Children of obese mothers more likely to get asthma

The UK National Institute for Health and Clinical Excellence (NICE) offers the following guidelines for managing your weight before, during and after pregnancy:

•    Ensure that physical activities such as walking, cycling and swimming are part of your everyday life.
•    Steer clear of diets, especially crash or fad diets as these could be harmful to foetal development.
•    Watch your portion sizes and forget about the old adage of “eating for two”.
•    Avoid high-fat foods that are high in sugar and kilojoules.
•    Make sure you eat five portions of fruit and vegetables daily.
•    Opt for fibre-rich foods.
•    Consult a nutritionist if you need more detailed dietary advice.

Pregnancy should be a wonderful life experience; not one fraught with concerns about your health and your baby’s healthy development because you’re carrying too much weight.

By losing weight before becoming pregnant and ensuring good weight management throughout the nine months, you’ll not only significantly reduce your risk of developing obesity-related conditions, but you’ll also be giving your little one a healthy start to life.

Read More:

Breastfeeding helps heavy moms drop weight
Aspirin may reduce pre-eclampsia risk
Vitamin D could make childbirth less painful

Image: Pregnant plus size woman from Shutterstock


- Jane E. Raymond et al. Gestational Weight Change in Women Attending a Group Antenatal Program Aimed at Addressing Obesity in Pregnancy in New South Wales, Australia. Journal of Midwifery & Women’s Health, Volume 59, Issue 4, pages 398–404, July/August 2014; ;David S. Ludwig et al. Pregnancy Weight Gain and Childhood Body Weight: A Within-Family Comparison, published online in PLOS Medicine, doi:10.1371/journal.pmed.1001521, 1 October 2013; N. L. Schumann et al, A review of national health policies and professional guidelines on maternal obesity and weight gain in pregnancy. Clinical Obesity Volume 4, Issue 4. Article first published online: 23 JUN 2014


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