Obesity during pregnancy puts child health at risk, says review

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Mothers who are obese during pregnancy are putting the health of their children at risk, a leading international expert has claimed.
High-risk pregnancies due to obesity are rising and putting pressure on prenatal clinics and delivery rooms across the world because of the “obesity epidemic”, a global review has concluded.
Obesity significantly raises the risk of gestational diabetes, which can develop into type 2 diabetes following birth if not properly controlled.
Pregnant, obese women are a new high-risk population and more resources are needed to tackle the problem, a series of review papers published this month in the Lancet Diabetes and Endocrinology has suggested.
Professor Patrick M. Catalano, who lead the work, said: “There is no doubt that we are all seeing an increase in pregnancy-related problems that are due to obesity all over the world,” adding “there is growing evidence that offspring of obese mothers are at high risk for excessive weight in childhood”.
“Obesity is associated with reduced fertility, and pregnancies complicated by maternal obesity are associated with adverse outcomes, including increased risk of gestational diabetes, pre-eclampsia, pre-term birth, instrumental and caesarean births, infections, and post-partum hemorrhage,” said the study authors.
The review papers by Catalano and fellow experts from Australia, Hong Kong and Brazil examined the clinical management of obesity in pregnancy and also looked at how to reduce risks to both the mother and child.
The researchers believe that apart from reducing excessive gestational weight gain, encouraging healthy eating and physical activity as well as behavioural changes during pregnancy have had limited impact in improving outcomes.
Instead, more comprehensive life-course approaches are needed that address diet and weight gain during pregnancy.
“The medical and obstetric management of obese women is focused on identifying, addressing, and preventing some of these associated complications, and is a daunting challenge given the high percentage of patients with obesity and few therapeutic options proven to improve outcomes in this population,” said Catalano.
“Basic questions as to what is the optimal diet or weight gain during pregnancy need to be addressed. In the interim, until a comprehensive potentially personalised life-course approach is instituted, efforts during pregnancy will by necessity be aimed at recognising and mitigating the adverse metabolic consequences of maternal obesity during pregnancy on both the mother and her child.”
The findings appear in The Lancet Diabetes and Endocrinology.