Seminars in Fetal & Neonatal Medicine
Volume 15, Issue 2 , Pages 77-82 , April 2010

Management of maternal obesity prior to and during pregnancy

  • H. Shaikh

      Affiliations

    • Department of Metabolic Medicine, 1st floor Mint Wing, Imperial College School of Medicine at St Mary's Hospital, London W2 1NY, UK
  • ,
  • S. Robinson

      Affiliations

    • Department of Metabolic Medicine, 1st floor Mint Wing, Imperial College School of Medicine at St Mary's Hospital, London W2 1NY, UK
    • Corresponding Author InformationCorresponding author. Tel.: +44 207 886 1678.
  • ,
  • T.G. Teoh

      Affiliations

    • Department of Obstetrics and Gynaecology, Imperial College School of Medicine at St Mary's Hospital, London W2 1NY, UK

References 

  1. World Health Organization . Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Geneva: WHO; 2004;
  2. Heslehurst N, Ells LJ, Simpson H, et al. Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36,821 women over a 15-year period. Br J Obstet Gynaecol. 2007;114:187–194
  3. Confidential Enquiry into Maternal and Child Health . In:  Lewis G editors. Saving mother's lives. Reviewing maternal deaths to make motherhood safer – 2003–2005. London: CEMACH; 2007;
  4. Heslehurst N, Lang R, Rankin J, et al. Obesity in pregnancy: a study of the impact of maternal obesity on NHS maternity services. Br J Obstet Gynaecol. 2007;114:334–342
  5. Frischknecht F, Brühwiler H, Raio L, et al. 2009 Changes in pre-pregnancy weight and weight gain during pregnancy: retrospective comparison between 1986 and 2004. Swiss Med Wkly. 2009;139:52–55
  6. Mendez MA, Monteiro CA, Popkin BM. Overweight exceeds underweight among women in most developing countries. Am J Clin Nutr. 2005;81:714–721
  7. Sebire NJ, Jolly M, Harris JP, et al. Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord. 2001;25:1175–1182
  8. O'Brien TE, Ray JG, Chan WS. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology. 2003;14:368–374
  9. Schrauwers C, Dekker G. Maternal and perinatal outcome in obese pregnant patients. J Matern Fetal Neonatal Med. 2009;22:218–226
  10. Cnossen J, Leeflang M, de Haan E, et al. Accuracy of body mass index in predicting pre-eclampsia: bivariate meta-analysis. Br J Obstet Gynaecol. 2007;114:1477–1485
  11. Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 2006;368(9542):1164–1170
  12. Yogev Y. Visser GH Obesity, gestational diabetes and pregnancy outcome. Semin Fetal Neonatal Med. 2009;14:77–84
  13. Dunne F, Brydon P, Smith K, et al. Pregnancy in women with Type 2 diabetes: 12 years outcome data 1990–2002. Diabet Med. 2003;20:734–738
  14. Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004;103:219–224
  15. Confidential Enquiry into Maternal and Child Health. In:  Acolet D editors. Perinatal mortality 2006: England, Wales and Northern Ireland. London: CEMACH; 2008;
  16. Kristensen J, et al. Pre-pregnancy weight and the risk of stillbirth and neonatal death. Br J Obstet Gynaecol. 2005;112:403–408
  17. Cnattingius S, Bergström R, Lipworth L, et al. Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med. 1998;15(338):147–152
  18. Stothard KJ, Tennant PW, Bell R, et al. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. J Am Med Assoc. 2009;301:636–650
  19. Wolfe HM, Sokol RJ, Martier SM, et al. Maternal obesity: a potential source of error in sonographic prenatal diagnosis. Obstet Gynecol. 1990;76:339–342
  20. Jolly MC, Sebire NJ, Harris JP, et al. Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies. Eur J Obstet Gynecol Reprod Biol. 2003;111:9–14
  21. Pedersen J, Bojsen-Moller B, Poulsen H. Blood sugar in newborn infants of diabetic mothers. Acta Endocrinol. 1954;15:33–52
  22. Hoegsberg B, Gruppuso PA, Coustan DR. Hyperinsulinemia in macrosomic infants of nondiabetic mothers. Diabetes Care. 1993;16:32–36
  23. Thomas CR. Placental transfer of non-esterified fatty acids in normal and diabetic pregnancy. Biol Neonate. 1987;51:94–101
  24. Schaefer-Graf UM, Graf K, Kulbacka I, et al. Maternal lipids as strong determinants of fetal environment and growth in pregnancies with gestational diabetes mellitus. Diabetes Care. 2008;31:1858–1863
  25. Di Cianni G, Miccoli R, Volpe L, et al. Maternal triglyceride levels and newborn weight in pregnant women with normal glucose tolerance. Diabet Med. 2005;22:21–25
  26. Kitajima M, Oka S, Yasuhi I, et al. Maternal serum triglyceride at 24–32 weeks' gestation and newborn weight in nondiabetic women with positive diabetic screens. Obstet Gynecol. 2001;97(5 Pt 1):776–780
  27. Heslehurst N, Simpson H, Ells LJ, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev. 2008;9:635–683
  28. Fedorcsak P, Storeng R, Dale PO, Tanbo T, Abyholm T. Obesity is a risk factor for early pregnancy loss after IVF or ICSI. Acta Obstet Gynecol Scand. 2000;79:43–48
  29. Clark AM, Thornley B, Tomlinson L, et al. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Hum Reprod. 1998;13:1502–1505
  30. Baeten JM, Bukusi EA, Lambe M, et al. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Publ Hlth. 2001;91:436–440
  31. Dresner M, Brocklesby J, Bamber J. Audit of the influence of body mass index on the performance of epidural analgesia in labour and the subsequent mode of delivery. Br J Obstet Gynaecol. 2006;113:1178–1181
  32. Mhyre JM. Anesthetic management for the morbidly obese pregnant woman. Int Anesthesiol Clin. 2007;45:51–70
  33. Rasmussen KM, Kjolhede CL. Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum. Pediatrics. 2004;113:465–471
  34. Linné Y, Dye L, Barkeling B, et al. Long-term weight development in women: a 15-year follow-up of the effects of pregnancy. Obes Res. 2004;12:1166–7838
  35. Mamun AA, O'Callaghan M, Callaway L. Associations of gestational weight gain with offspring body mass index and blood pressure at 21 years of age: evidence from a birth cohort study. Circulation. 2009;119:1720–1727
  36. Moreira P, Padez C, Mourão-Carvalhal I, et al. Maternal weight gain during pregnancy and overweight in Portuguese children. Int J Obes (Lond). 2007;31:608–614
  37. Baker JL, Gamborg M, Heitmann BL, et al. Breastfeeding reduces postpartum weight retention. Am J Clin Nutr. 2008;88:1543–1551
  38. Hytten F. Clinical physiology in obstetrics. Oxford: Blackwell; 1991;p. 150–172
  39. Forsum E, Löf M. Energy metabolism during human pregnancy. Annu Rev Nutr. 2007;27:277–292
  40. Institute of Medicine . Nutrition during pregnancy, weight gain and nutrient supplements. Report of the Subcommittee on Nutritional Status and Weight Gain during Pregnancy, Subcommittee on Dietary Intake and Nutrient Supplements during Pregnancy, Committee on Nutritional Status during Pregnancy and Lactation, Food and Nutrition Board. Washington, DC: National Academy Press; 1990;p. 1–233
  41. Abrams B, Altman SL, Pickett KE. Pregnancy weight gain: still controversial. Am J Clin Nutr. 2000;71:1233S–1242S
  42. Olson CM. Achieving a healthy weight gain during pregnancy. Annu Rev Nutr. 2008;28:411–423
  43. Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynecol Obstet. 2006;93:269–274
  44. Wells CS, Schwalberg R, Noonan G, et al. Factors influencing inadequate and excessive weight gain in pregnancy: Colorado, 2000–2002. Matern Child Health J. 2006;10:55–62
  45. Stuebe AM, Oken E, Gillman MW. Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain. Am J Obstet Gynecol. 2009;201:58
  46. Claesson IM, Sydsjo G, et al. Weight gain restriction for obese pregnant women: a case–control intervention study. Br J Obstet Gynaecol. 2008;115:44–50
  47. Asbee SM, Jenkins TR, Butler JR, et al. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstet Gynecol. 2009;113(2 Pt 1):305–312
  48. Polley BA, Wing RR, Sims CJ, et al. Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord. 2002;26:1494–1502
  49. Olson CM, Strawderman MS, Reed RG, et al. Efficacy of an intervention to prevent excessive gestational weight. Am J Obstet Gynecol. 2004;191:530–536
  50. O'Toole ML, Sawicki MA, Artal R, et al. Structured diet and physical activity prevent postpartum weight retention. J Women's Health (Larchmt). 2003;12:991–998
  51. Kinnunen TI, Pasanen M, Aittasalo M, et al. Reducing postpartum weight retention – a pilot trial in primary health care. Nutr J. 2007;6:21
  52. Picciano MF. Pregnancy and lactation: physiological adjustments, nutritional requirements and the role of dietary supplements. J Nutr. 2003;133:1997S–2002S
  53. Panel on Macronutrients , Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes . Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). National Academy of Sciences, Institute of Medicine, Food and Nutrition Board; 2005;
  54. Lagiou P, Tamimi RM, Mucci LA, et al. Diet during pregnancy in relation to maternal weight gain and birth size. Eur J Clin Nutr. 2004;58:231–237
  55. Kramer MS, Kakuma R. Energy and protein intake in pregnancy. Cochrane Database Syst Rev. 2003;(4):CD000032
  56. Reader DM. Medical nutrition therapy and lifestyle interventions. Diabetes Care. 2007;30(Suppl. 2):S188–S193
  57. Mumford SL, Siega-Riz AM, Herring A, et al. Dietary restraint and gestational weight gain. J Am Diet Assoc. 2008;108:1646–1653
  58. Moses RG, Luebcke M, Davis WS, et al. 2006 Effect of a low-glycemic-index diet during pregnancy on obstetric outcomes. Am J Clin Nutr. 2006;84:807–812
  59. Scholl TO, Chen X, Khoo CS, et al. The dietary glycemic index during pregnancy: influence on infant birth weight, fetal growth, and biomarkers of carbohydrate metabolism. Am J Epidemiol. 2004;159:467–474
  60. Gavard JA, Artal R. Effect of exercise on pregnancy outcome. Clin Obstet Gynecol. 2008;51:467–480
  61. Clapp JF. The effects of maternal exercise on fetal oxygenation and feto-placental growth. Eur J Obstet Gynecol Reprod Biol. 2003;110(Suppl. 1):S80–S85
  62. Artal R, Catanzaro RB, Gavard JA, et al. A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus. Appl Physiol Nutr Metab. 2007;32:596–601
  63. Fell DB, Joseph KS, Armson BA, et al. The impact of pregnancy on physical activity level. Matern Child Health J. 2008;
  64. Juhl M, Andersen PK, Olsen J, et al. Physical exercise during pregnancy and the risk of preterm birth: a study within the Danish National Birth Cohort. Am J Epidemiol. 2008;167:859–866
  65. Schlüssel MM, Souza EB, Reichenheim ME, et al. Physical activity during pregnancy and maternal–child health outcomes: a systematic literature review. Cad Saude Publica. 2008;24(Suppl 4):s531–s544
  66. Østerdal M, Strøm M, Klemmensen A, et al. Does leisure time physical activity in early pregnancy protect against pre-eclampsia? prospective cohort in danish women. Br J Obstet Gynaecol. 2009;116:98–107
  67. Madsen M, Jørgensen T, Jensen M, et al. Leisure time physical exercise during pregnancy and the risk of miscarriage: a study within the Danish National Birth Cohort. Br J Obstet Gynaecol. 2007;114:1419–1426
  68. Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery: a systematic review. J Am Med Assoc. 2008;300:2286–2296
  69. American College of Obstetricians and Gynecologists Committee Opinion . Obesity in pregnancy. Obstet Gynecol. 2005;106:671–675

    *The most important references are indicated with an asterisks.

PII: S1744-165X(09)00103-6

doi: 10.1016/j.siny.2009.10.003

Seminars in Fetal & Neonatal Medicine
Volume 15, Issue 2 , Pages 77-82 , April 2010