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Starting a pregnancy while overweight increases the risk of a preterm delivery

Thomas Secrest's picture
Risks for preterm delivery

Newer research highlights the importance of starting your pregnancy without being overweight. The finding suggests women whose body mass index is high when they get pregnant have an increased chance of preterm delivery.

There have been some truly amazing advances in neonatal medicine in the last couple of decades. Children who decide to make an appearance a little before term can now be safely received into the awaiting, if somewhat hostile, world. Nonetheless, it’s hard to find an OB/GYN who wouldn't prefer a term delivery over a preterm delivery, even if it’s just a few days preterm.

No matter how hard we try, we still don’t have the technology to replicate momma’s womb, which means, for now anyway, that’s where baby belongs right up until its appointed time to exit the womb and make its grand entrance onto the stage of life.

What are the risk factors linked to a preterm delivery?

There are a number of factors that increase the risk of having a preterm delivery. They include:
• A previous preterm delivery
• A pregnancy with twins or triplets
• In vitro fertilization
• Uterine complications during pregnancy
• High blood pressure
• Diabetes
• Cigarette smoking
• Alcohol use
• Younger age (especially teenage pregnancies)
• Lack of prenatal care
• Poor nutrition
• Untreated infections during pregnancy (in particular uterine or urinary)
• Previous miscarriages

What pregnancy risks are associated with overweight and obesity?

It is fairly well established that being overweight or obese increases the risk of preeclampsia, miscarriage, gestational diabetes and the need for a cesarean delivery. However the jury, until recently, was out on whether it led to preterm deliveries. Apparently the jury has now come in.

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In a recent study, published in the June 12, 2013, issue of the JAMA, Sven Cnattingius, MD, wrote that “Maternal overweight and obesity has, due to the high prevalence and associated risks, replaced smoking as the most important preventable risk factor for adverse pregnancy outcomes in many countries.”

The study reviewed records from 1,599,551 patients, from 1992 – 2010. The records indicated that of the one and a half million deliveries, just over 3000 were extremely preterm (22 – 27 weeks), just under 7000 were very preterm (28 – 31 weeks) and a tad over 67,000 were moderately preterm (32 –36 weeks). Next the researchers determined body mass index (BMI) for the patients and looked for a correlation between various levels of BMI and preterm deliveries.

As you might have guessed there was a correlation. Within each category of preterm (i.e. extremely, very and moderately) as BMI increased, so did the risk of having a preterm delivery.

What is it about being overweight or obese that increases the risk?

This question is still under investigation. It is thought, however, that overweight or obesity may act indirectly by compounding problems associated with existing or pre-existing diabetes and high blood pressure. Additionally, it is important to realize that being overweight or obese does not necessarily mean good nutrition. It can easily mean an overabundance of food having little nutritional value. In that sense, overweight or obesity may also impact the risk of preterm delivery through poor nutrition.

Being pregnant is a huge burden on a woman’s physiology. We know from multiple studies that the same can be said for being overweight or more particularly obese. So it’s not hard to imagine that the combination is potentially risky to mom and fetus. If there is obesity linked diabetes or hypertension the strain on the mother and the pregnancy climbs still further.

As you plan for your pregnancy, make sure to factor in some exercise and a good, nutritional diet. When those cravings hit, do what you can to satisfy them with foods that don’t put on too many pounds; and when it’s time to spoil yourself, do it with a short walk, your body and your baby will thank you.

Reference: MPR