Obesity and Pregnancy Essay

Have you ever leisurely walked down an isle at Target and noticed a pregnant women waddling from side to side and thought to yourself man she is fat? Well she really is. Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and increased health problems. Maternal obesity is a major risk factor in short term for both maternal and fetal complications, including maternal and fetal mortality, miscarriages, gestational diabetes mellitus (GDM), pregnancy-induced hypertensive disorders, marcrosomia and caesarean sections. A baby could be affected by these tragic events up until the age of 18. This rise of the obesity rate has a devastating impact on implications for the nation’s health care system and the population’s future quality of life. The normal weight for women is (BMI 19. 8– 25. 9), (BMI 26– 29) for overweight women and a BMI over 30 is considered obese. BMI is known as Body Mass Index, which is a number calculated based on weight and height. Pregnant women gain excess weight due to the lack of exercise. The majority of women do not know that they can continue exercising at least three times per week during pregnancy. Women should be more informed about everything they should and should not do during their pregnancy. The most common type of exercise for pregnant women is walking. Gardening, aerobics, and usage of exercise machines are also means of exercising. Exercise also has many other beneficial health effects such as reduced incidence of type 2 diabetes, hypertension, and certain cancers as well as improved quality of life and emotional status1. If you conceived the child then why not exercise instead of a chance at miscarrying it? A pregnant woman’s diet is an essential part of her pregnancy. times out of 10, a pregnant woman constantly hears from her peers that she needs to eat more since she is eating for two. We forget the fact that she could potentially become obese. From a doctor’s standpoint, he should take the initiative to urge the mother not to go overboard with eating. Both mother and baby need a balanced diet full of varied fruits, vegetables, lean proteins, unsaturated plant-based fats, fiber and calcium. Refined grains, most processed foods and foods high in sugar and saturated fats should be avoided. The development of the baby’s organs and bones depend on obtaining sufficient nutrients from the mother. Despite the fact that pregnant women do not need to become obese they also do not need to diet during pregnancy. Maternal obesity is associated with an overall higher rate of labor induction, which requires higher oxytocin and prostaglandin doses than for women of normal BMI. Oxytocin is responsible for stimulation of milk ejection (milk letdown) and for stimulation of uterine smooth muscle contraction at birth. Prostaglandins are important mediators of uterine activity. It is very common for an obese woman to have a cesarean section instead of a natural pregnancy. Obese women are two to three times more likely to have an emergency cesarean due to factors such as a large baby or failure to progress. Why would you want to go through the agony of getting cut open like a dissected pig when it isn’t necessary? Maternal overweight and diabetes (gestational and type 2) has repeatedly been associated with a number of delivery complications, which includes prolonged birth, birth asphyxia, shoulder dystocia, injuries to the baby and the mother, increased use of instrumental vaginal deliveries and cesarean sections, and postpartum hemorrhaging2. Some long-term effects are also associated with obesity in pregnancy such as an increased risk of having diabetes and cardiovascular disease later in life. During pregnancy, serum markers of inflammation are raised in overweight and obese women when compared with their normal BMI counterparts2. Other problems during pregnancy also link with chronic inflammation. Cord blood from babies born to obese mothers also has lower mean vitamin D concentrations when compared to those born of women with normal BMI. A fetus depends on maternal skin exposure for activation of vitamin D, but if the mother is obese then it is likely that she is vitamin D deficient. There is consequently significant scientific evidence to support the requirement for maternal vitamin D sufficiency in pregnancy for normal development of the fetal brain and skeleton. Folate deficiency is also common in obese pregnant women. Folate deficiency in the general pregnant population is associated with an increased risk for fetal neural tube defect, and this risk is reduced by the use of pre-conceptual folate2. Data from the National Maternal and Infant Health Survey showed that among the women who gained more than the recommended weight during pregnancy, greater than 30% retained an average of 2. 5 kgs at 10 to 18 months postpartum as opposed to retention of 1 kg among women who gained at the recommended level1. If women are encouraged to keep weight off during their pregnancy then they won’t have to face obesity postpartum. Researchers are still in the process of finding other ways to prevent obesity during pregnancy such as efficient ways to diet. Provision of weight management services to advise and educate regarding obesity-associated obstetric risk and weight optimization prior to conception is strongly recommended2. One thing that women would not normally categorize as such a big issue is regularly monitoring their blood pressure, which would be a start of becoming a healthy mother. Screening for gestational diabetes, using a 75 g OGTT, should be undertaken in all women with BMI 30 kg/m 2 between 24 and 28 weeks gestation2. No women should want to look and feel as fat as an elephant. Therefore, it is beneficial to continue physical activity after having a baby. The measurement of psychosocial attributes in the postpartum period has largely focused on postpartum depression and social support, with little attention to the role these and other psychosocial factors may play in health behaviors associated with weight retention and activity3. During pregnancy, some women are distressed about their weight and think they have a negative body image. Some say that they feel as if they are as big as a house. Postpartum depression has received much attention among clinicians because 10-16% of women meet diagnostic criteria for major depression. Women with excessive pregnancy weight gain (>20? kg) gain up to 10. Â ±2. 1? kg of adipose tissue4. If a woman plans on having another child after being obese during the first pregnancy then she will most likely be obese during her second pregnancy. One would not believe something so detrimental to your health, such as a smoker continuing to smoke during pregnancy would produce no weight gain. It is astounding that those who don’t smoke could gain more than those who do. The Stockholm Pregnancy and Weight Development Study on 1423 women concluded that, apart from pregnancy weight gain, only smoking cessation can be considered as a predictor for persistent weight gain after 1 year postpartum4. Lactation is known as something to facilitate weight loss after pregnancy. Production of milk is an energy-requiring process and has been calculated to increase energy requirements by ~ 500? kcal per day4. This is due to the fact that the net efficiency of milk synthesis in women is high. Weight changes after delivery are dependent on factors other than lactation status. Sarah Leigh, a 30-year-old obese pregnant mother, found out she had gestational diabetes. Sarah was very self-conscious about this situation and does not wish to report anything other than her name and age. She describes the daunting changes she had to make in her day-to-day lifestyle. Sarah Leigh had to check her blood sugar levels up to six times a day. The sugary sweets that Sarah Leigh usually enjoyed would now have to be cut out altogether. There would be no chocolate and fruit even had to be eaten in moderation. Even though Sarah Leigh made the changes to her diet, her blood levels were still high and she had to be put on medication to control the diabetes. Sarah Leigh explained how even though she felt deprived of all her favorite foods she feels healthier. Sarah enjoys her new lifestyle of eating a wide variety of foods. As long as she eats in moderation then her blood sugars remain balanced. Sarah talked about how there were times when she just wanted to taste a chocolate bar, but she knew that she and the baby were better off without it. Sarah would like to express to everyone that if they feel they have a slight chance of having gestational diabetes to go to your doctor immediately. The sooner it is treated then mother and the child are in better shape. Behavioral interventions, such as advising women of the recommended weight gain ranges, and promoting healthy dietary intake and regular exercise during the prenatal and postpartum periods may prove important in preventing obesity and the related health problems later in life. People should keep in mind that body weight tends to increase with age, irrespective of whether women have children or not. A pregnancy should be carefully planned. Two lives are at stake instead of one.