Module Content

 

 

 

Lifestyle: Weight                                                   

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Women should be counseled, as follows, with respect to their BMI about their weight status and its effect on their reproductive future . . .

 

 

Overweight / Obesity

 

  • Fertility, maternal morbidity, and perinatal mortality are no exception to this unfortunate relationship. Prepregnancy obesity has been associated with increased incidence of:

  • NTD

  • preterm delivery

  • stillbirth

  • gestational DM

  • hypertensive and thromboembolic disorders

  • macrosomia

  • low Apgar scores

  • postpartum anemia

  • cesarean delivery

  • shoulder dystocia

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  • Thinking back to the section on chronic medical conditions and incorporating your knowledge about obesity, it is easy to connect these ideas. Because hypertension and diabetes are frequently comorbid with obesity, the pregnancy outcomes for those conditions also apply to obese women with those conditions.

  • Because weight loss is contraindicated at any point during pregnancy, it is vital that this topic be discussed with your reproductive age patients before they attempt to become pregnant. They must be counseled on their weight and its risk for their reproductive future as well as general health and well-being.

  • Current ACOG recommendations are for weight-reduction-specific counseling occurring at least monthly with or without pharmacotherapy. ACOG recommends a goal of a 5-10% weight loss over a 6 month period as realistic and achievable. A 10% weight loss is almost always noticeable to the patient.

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