Changes in body weight as a possible cause of obstetric complications

iStock_000017779437XSmallThe research conducted by scientists from the Swedish Research Council for Health, Working Life and Welfare, and the Karolinska Institutet, shows that changes in body weight between successive pregnancies may affect the risk of intrauterine fetal death and increased infant mortality.

Obesity is sometimes called a pandemic of XXI century. Its incidence is increasing rapidly, especially in the population of developed and developing countries. It is estimated that the problem of overweight concerns 50% of Europeans over the age of 18 and obesity affects 30% of them. According to epidemiological studies in Europe overweight women comprise more than twenty percent of females, while obesity concerns 6-8% of them.

Unfortunately, in recent years obesity has also been more frequently diagnosed among children and adolescents. Although the complications of obesity related to cardiovascular system, such as hypertension, ischemic heart disease or stroke, are commonly known, relatively little is said about obstetric complications associated with changes in body weight between subsequent pregnancies.

Available studies indicate an increased risk of intrauterine fetal death or an increase in infant mortality in a population of obese mothers, as compared to mothers with normal BMI. Other prenatal complications of obesity, such as pregnancy induced hypertension, gestational diabetes, preeclampsia, eclampsia, premature labor, premature spontaneous rupture of membranes, prolonged duration of pregnancy and many others have been identified. The research of the Swedish scientists did not relate to the problem of obesity and underweight among pregnant women, but it specifically concerned weight changes of women between subsequent pregnancies.

The study covered 587 710 women who gave birth twice during the study. Complete information was obtained from 456 711 (77.7%) of them. The survey was conducted on a population of Swedish women in the period from 1 January 1992 to 31 December 2012. Among women whose BMI growth amounted to 4 units compared to women with normal BMI (<25 kg/m2) an increased risk of intrauterine fetal death and increased mortality of newborns and infants was observed. The researchers noted that the risk increases linearly with increasing BMI of the mother. Among those overweight women (with BMI> 25kg/m2) who stabilised their weight between subsequent pregnancies, there was a reduced risk of infant mortality.

The findings point to the need of raising the awareness of women who plan to become pregnant, as to the significant risk associated with changes in body weight. Women planning the birth of a child should consult their physician on how to effectively prevent the occurrence of overweight and obesity. Obese women should get help in the normalization of weight due to a planned pregnancy.

Written by: Kai Wróblewski, Karolina Dudek, Małgorzata Wołowik

1. Cnattingius S, Villamor E. Weight change between successive pregnancies and risks of stillbirth and infant mortality: a nationwide cohort study. Lancet. 2015 Dec 2. pii: S0140-6736(15)00990-3. doi: 10.1016/S0140-6736(15)00990-3. [Epub ahead of print].
2. Longina Kłosiewicz-Latoszek. Obesity as a social, medical and therapeutic problem. Probl Hig Epidemiol 2010, 91(3): 339-343
3. Karolina Paulina Bebelska, Ewa Ehmke Vel Emczyńska, Ewa Gmoch-Gajzlejerska. OBESITY AS A FACTOR DISTURBING REPRODUCTIVE PROCESSES. Nowiny Lekarskie 2011, 80, 6, 499–507

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